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

Iopamidol 370 mg/ml has an iodine concentration of 370 mg/ml, which falls in the 300-399 mg/ml range, corresponding to HCPCS Q9967.

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

A9578 is the HCPCS code for gadoxetate disodium (Eovist), a hepatocyte-specific MRI contrast agent, while A9576 is gadopentetate dimeglumine, A9577 is gadobenate dimeglumine, and A9579 is gadolinium NOS.

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

Injectable premedication drugs administered in the facility to prevent contrast reactions are separately billable using appropriate HCPCS/J-codes in addition to the imaging procedure code.

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

Barium sulfate for GI studies falls below CMS's packaging threshold and is packaged into the APC payment under OPPS, making it non-separately reimbursable to the outpatient facility.

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

Many Medicare Advantage plans require prior authorization for advanced imaging studies with contrast such as MRI with gadolinium, as these represent higher-cost services subject to utilization management.

RCC - Radiology Certified Coder Practice Test

RCC - Radiology Certified Coder Practice Test

RCC Contrast Media, Supplies & HCPCS Level II Coding 3