RCC Contrast Media, Supplies & HCPCS Level II Coding 3

Question 1

A hospital outpatient CT angiography uses 100 ml of iopamidol 370 mg/ml iodine concentration. Which HCPCS code correctly describes this low-osmolality contrast?

Accepted Answer

Q9967 (LOCM, 300-399 mg/ml iodine, per ml)

Answer

Q9965 (LOCM, 100-199 mg/ml iodine, per ml)

Answer

Q9966 (LOCM, 200-299 mg/ml iodine, per ml)

Answer

Q9951 (LOCM, 400 or greater mg/ml iodine, per ml)

Question 2

Which HCPCS code is specifically assigned to gadoxetate disodium (Eovist/Primovist), a hepatocyte-specific MRI contrast agent used for liver imaging?

Accepted Answer

A9578

Answer

A9576

Answer

A9577

Answer

A9579

Question 3

When a patient with documented contrast allergy receives injectable premedication (e.g., methylprednisolone, diphenhydramine) at the facility before a contrast-enhanced CT, how should the premedication drugs be reported?

Accepted Answer

Separately, using the appropriate HCPCS/J-codes for each injectable drug administered

Answer

Not separately; premedication is always bundled with the imaging procedure

Answer

Only if the patient is admitted as an inpatient that day

Answer

Reported under the patient's outpatient pharmacy benefit exclusively

Question 4

Barium sulfate administered for an upper GI (UGI) series in a hospital outpatient setting is typically handled under OPPS as:

Accepted Answer

Packaged into the APC payment and not separately reimbursed by Medicare

Answer

Separately billable using a HCPCS Q-code for the volume administered

Answer

Reported with a J-code for oral administration of a contrast agent

Answer

Covered only under the patient's Part D pharmacy benefit

Question 5

Under Medicare Advantage (MA) plans, which imaging service is most commonly subject to prior authorization requirements related to contrast use?

Accepted Answer

MRI brain with gadolinium contrast for headache evaluation

Answer

Routine chest X-ray with contrast markers

Answer

CT colonoscopy without contrast material

Answer

Plain abdominal radiograph, two views

Question 6

A radiologist performs a fluoroscopy-guided joint injection and uses non-ionic iodinated contrast to confirm needle placement. The contrast volume used is 2 ml of ioversol 320 mg/ml. How should this contrast be coded?

Accepted Answer

Reported on the facility/technical claim using Q9966 × 2 units (per ml)

Answer

Bundled into the fluoroscopy guidance CPT code; no separate contrast code needed

Answer

Reported using J3301 (injection, triamcinolone acetonide) as the drug code

Answer

Reported using A9579 as gadolinium NOS contrast

Question 7

A radiology coder reviews a CT chest order noting 'CT chest with and without contrast.' The correct CPT code to report is:

Accepted Answer

71270 (CT thorax, without contrast followed by re-imaging with contrast)

Answer

71250 (CT thorax, without contrast)

Answer

71260 (CT thorax, with contrast)

Answer

71275 (CT angiography, chest, with contrast)