2025 HCPCS code A9505
(Active) Effective Date: N/A Radiopharmaceuticals - Diagnostic and Therapeutic Radiopharmaceuticals A Codes Feed
Thallium Tl-201 thallous chloride, diagnostic, per millicurie.
Medical necessity for the use of A9505 must be supported by the patient's clinical presentation, signs, and symptoms suggesting conditions like coronary artery disease, myocardial ischemia, or hyperparathyroidism, making the diagnostic imaging procedure necessary for proper evaluation and management.
The clinician is responsible for the safe and appropriate administration of the radiopharmaceutical, including handling precautions due to radiation, correct dosage based on the patient's condition, and interpretation of the nuclear medicine images obtained.
In simple words: This code represents a small amount of a radioactive material called Thallium Tl-201, which is used in heart scans. It helps doctors see how well blood is flowing to the heart muscle.
Supply of Thallium Tl-201 thallous chloride for diagnostic purposes in nuclear medicine imaging, used to detect coronary artery disease.Administered intravenously, each milliliter contains 1 millicurie (mCi) of the radioactive agent.
Example 1: A patient presents with chest pain and shortness of breath, raising suspicion for coronary artery disease. A Thallium-201 stress test is ordered to evaluate myocardial perfusion., A patient with a history of heart problems undergoes a Thallium-201 scan to assess the viability of heart tissue before a planned surgical intervention., A patient with suspected hyperparathyroidism is given a Thallium-201 scan to locate overactive parathyroid glands.
Documentation should include the medical necessity for the Thallium-201 scan (e.g., symptoms, prior cardiac history), the dosage administered, the route of administration (intravenous), and the results of the imaging study, including the interpretation by a qualified professional.
** Medicare reimbursement is based on carrier judgment. The half-life of Tl-201 is approximately 73 hours.
- Payment Status: Active
- Specialties:Cardiology, Nuclear Medicine, Endocrinology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Independent Clinic, Physician's Office