PET radiopharmaceuticals have their own unique HCPCS codes that can be reported on claims. Please be advised that CMS prohibits the use of the miscellaneous code A4641 Radiopharmaceutical, diagnostic, not otherwise classified, on PET claims.
Below is a list of PET radiopharmaceuticals and their respective codes:
| Radiopharmaceutical | Trade Name | HCPCS Code |
|---|---|---|
| Nitrogen n-13 Ammonia | Ammonia | A9526 |
| Fluorodeoxyglucose F-18 FDG | F18 FDG | A9552 |
| Rubidium rb-82 | CardioGen-82 | A9555 |
| Sodium Fluoride F-18 | F18, NaF, Sodium Fluoride | A9580 |
| Choline C-11 | C-11 Choline | A9515 |
| Fluciclovine F-18 | Axumin™ | A9588 |
| Gallium ga-68 dotatate | NETSPOT™ | A9587 |
| Florbetapir F-18 | Amyvid™ | A9586 |
| Flutemetamol F-18 | Vizamyl™ | Q9982 |
| Florbetaben F-18 | NeuraCeq™ | Q9983 |
| Newly FDA-approved PET tracers without an assigned HCPCS code can use one of the following codes: |
|---|
| A9597 Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified |
| A9598 Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified |
| For 2018, CMS has discontinued the HCPCS code |
|---|
| A9599 Radiopharmaceutical, diagnostic, for beta-amyloid positron emission tomography (PET) imaging, per study dose |
