Does A9582 require prior authorization?

No, A9582 does not require prior authorization (medium confidence). Covered without prior authorization by at least one policy, though another does not cover it.

What is the Medicare reimbursement rate for A9582?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`A9582`, Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Covered without prior authorization by at least one policy, though another does not cover it (medium confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Carefully check state regulations and/or the member contract.

Key Coverage Criteria

Myocardial sympathetic innervation imaging with iodine-123 MIBG is not covered for heart failure (considered experimental/investigational/unproven).
Coverage is restricted: myocardial sympathetic innervation imaging with iodine 123 meta-iodobenzylguanidine is considered experimental, investigational and/or unproven for use in individuals with heart failure.

5 Active Policies

ANTHEM-RAD.00064, Myocardial Sympathetic Innervation Imaging with or without Single-Photon Emission Computed Tomography (SPECT)

BCBSIL-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

BCBSMT-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

BCBSNM-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

BCBSOK-RAD604.012, Myocardial Sympathetic Innervation Imaging in Individuals With Heart Failure

`A9582`, Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

5 Active Policies

Related Codes

Have a follow-up question?

A9582, Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

5 Active Policies

Related Codes

Have a follow-up question?

`A9582`, Iodine i-123 iobenguane, diagnostic, per study dose, up to 15 millicuries