Question 1

What is HCPCS code A9516?

Accepted Answer

HCPCS code A9516 is "Iodine i-123 sod iodide mic". Iodine i-123 sodium iodide, diagnostic, per 100 microcuries, up to 999 microcuries

Question 2

What category is A9516 in?

Accepted Answer

A9516 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A9516?

Accepted Answer

Use A9516 when billing for iodine i-123 sod iodide mic. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is A9516 covered by Medicare?

Accepted Answer

Coverage for A9516 (Iodine i-123 sod iodide mic) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for A9516?

Accepted Answer

Documentation for A9516 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).