2025 HCPCS code A4642
Indium In-111 satumomab pendetide, a monoclonal antibody used to locate and determine the extent of cancer cells during tumor imaging or treatment (up to 6 mCi).
Medical necessity for A4642 is established by the presence of known or suspected colorectal or ovarian cancer, and the need to determine the location and extent of the disease to guide treatment decisions.
The physician is responsible for administering the Indium In-111 satumomab pendetide intravenously, conducting the CT imaging, interpreting the results, and using the findings to guide treatment decisions for patients with colorectal or ovarian cancer.
In simple words: This is a special type of scan that helps doctors find and see how big colorectal or ovarian cancer is. A substance is injected into the vein that sticks to the cancer cells. Then, a special x-ray, called a CT scan, is taken to show where the cancer is and how far it has spread.
Indium In-111 satumomab pendetide is a monoclonal antibody used in patients with known colorectal or ovarian cancer to determine the extent and location of cancer cells. This antibody detects a protein found on the surface of most ovarian and colorectal cancers. It is administered intravenously and attaches to cancer cells. Computed tomography (CT) images are then taken to visualize the extent of the tumor and its spread. This information assists providers in making preoperative and treatment decisions. This code is reported for each study dose up to 6 millicuries (mCi).
Example 1: A patient with a history of colorectal cancer presents with rising tumor markers. A4642 is used to assess for recurrent or metastatic disease before a surgical exploration., A patient with ovarian cancer is undergoing pre-surgical evaluation. A4642 is used to determine the extent of the disease and to guide surgical planning., A patient with known colorectal cancer is being considered for a new chemotherapy regimen. A4642 is used to assess the current tumor burden and to monitor response to therapy.
Documentation should include the diagnosis of colorectal or ovarian cancer, the dosage of Indium In-111 satumomab pendetide administered (up to 6 mCi), the date of administration, the results of the CT imaging, and how these results influence the treatment plan.
- Specialties:Oncology, Nuclear Medicine, Radiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Independent Clinic