Institutional providers billing the A/B MAC (A)
*A9555 Rubidium Rb-82, Diagnostic, Per study dose, Up To 60 Millicuries
* Q3000 (Deleted effective 12/31/05) Supply of Radiopharmaceutical Diagnostic Imaging Agent, Rubidium Rb-82, per dose
A9526 Nitrogen N-13 Ammonia, Diagnostic, Per study dose, Up To 40 Millicuries
NOTE: For claims with dates of service prior to 1/01/06, providers report Q3000 for supply of radiopharmaceutical diagnostic imaging agent, Rubidium Rb-82. For claims with dates of service 1/01/06 and later, providers report A9555 for radiopharmaceutical diagnostic imaging agent, Rubidium Rb-82 in place of Q3000.
*A4641 Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified
A9526 Nitrogen N-13 Ammonia, Diagnostic, Per study dose, Up To 40 Millicuries
A9555 Rubidium Rb-82, Diagnostic, Per study dose, Up To 60 Millicuries
*NOTE: Effective January 1, 2008, tracer code A4641 is not applicable for PET Scans.
* A9552 Fluorodeoxyglucose F18, FDG, Diagnostic, Per study dose, Up to 45 Millicuries
* C1775 (Deleted effective 12/31/05) Supply of Radiopharmaceutical Diagnostic Imaging Agent, Fluorodeoxyglucose F18, (2- Deoxy-2-18F Fluoro-D-Glucose), Per dose (4-40 Mci/Ml)
**A4641 Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified
A9580 Sodium Fluoride F-18, Diagnostic, per study dose, up to 30 Millicuries
NOTE: For claims with dates of service prior to 1/01/06, OPPS hospitals report C1775 for supply of radiopharmaceutical diagnostic imaging agent, Fluorodeoxyglucose F18. For claims with dates of service 1/01/06 and later, providers report A9552 for radiopharmaceutical diagnostic imaging agent, Fluorodeoxyglucose F18 in place of C1775.
**NOTE: Effective January 1, 2008, tracer code A4641 is not applicable for PET Scans.
***NOTE: Effective for claims with dates of service February 26, 2010 and later, tracer code A9580 is applicable for PET Scans.
A9552 Fluorodeoxyglucose F18, FDG, Diagnostic, Per study dose, Up to 45 Millicuries
*A4641 Supply of Radiopharmaceutical Diagnostic Imaging Agent, Not Otherwise Classified
A9580 Sodium Fluoride F-18, Diagnostic, per study dose, up to 30 Millicuries
*NOTE: Effective January 1, 2008, tracer code A4641 is not applicable for PET Scans.
***NOTE: Effective for claims with dates of service February 26, 2010 and later, tracer code A958
