Current Codes in 223Ra-Dichloride Therapy (27)
| Code | Purpose |
|---|---|
| CPT code 99242 (new, outpatient, problem-focused, 30 min) | Code for evaluation and management (dependent on type and length of consultation) |
| CPT code 79101 | Code for radiopharmaceutical therapy by intravenous administration |
| Radiopharmaceutical code A9606 | Code for therapeutic 223Ra-dichloride, per microcurie |
| JW modifier | Code to report wasted product and ensure ability to report full cost of ordered dose* |
| ICD-10-CM codes (C61: malignant neoplasm of prostate; C79.51: secondary malignant neoplasm of bone) | Codes to support the above codes and ensure correct indication |
↵* Given long half-life, may not be needed, but Society of Nuclear Medicine and Molecular Imaging supports use of this modifier.
CPT = Current Procedural Terminology; JW modifier = Healthcare Common Procedure Coding System (HCPCS) Level II modifier used on Medicare Part B drug claim to report amount of drug or biological that is discarded and eligible for payment under the discarded drug policy (32); ICD-10-CM = International Classification of Diseases, tenth revision, clinical modification.