Coding for aerosol version of DTPA used with ventilation and perfusion imaging

Q.

Regarding radiopharmaceutical charging, are we able to assign HCPCS codes A9539 and A9540 when a ventilation and perfusion scan is performed? Medicare is denying HCPCS A9539. If not, which codes should we be billing?

A.

It is best to use Level II HCPCS code A9567 instead of A9539. HCPCS code A9567 is the aerosol version of DTPA used for lung ventilation procedures. If you perform both ventilation and perfusion imaging, you can report both HCPCS codes (A9540 and A5967). There is no conflict when you use HCPCS A9567 instead of HCPCS A9539.

The codes and full description are as follows:

A9539 Technetium Tc-99m pentetate, diagnostic, per study dose, up to 25 mCi

A9540 Technetium Tc-99m macroaggregated albumin, diagnostic, per study dose, up to 10 mCi

A9567 Technetium Tc-99m pentetate, diagnostic, aerosol, per study dose, up to 75 mCi