Current Codes in 223Ra-Dichloride Therapy (27)

CPT code 99242 (new, outpatient, problem-focused, 30 min)Code for evaluation and management (dependent on type and length of consultation)
CPT code 79101Code for radiopharmaceutical therapy by intravenous administration
Radiopharmaceutical code A9606Code for therapeutic 223Ra-dichloride, per microcurie
JW modifierCode 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.