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Coding for high-osmolar contrast material

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Q.

Is there a CPT or HCPCS code for CYSTOGRAFIN® (diatrizoate meglumine injection USP 30%), 300 ml bottle?

A.

Yes, the Level ll HCPCS code for CYSTOGRAFIN® (diatrizoate meglumine injection USP 30%) is Q9958 – High osmolar contrast material, up to 149 mg/ml iodine concentration, per ml.

As a high osmolar contrast material, Medicare considers it bundled into the imaging procedure for which it is used and not paid separately. This same stipulation applies to non-hospital imaging centers and offices. The following is found in the Internet Only Manual (IOM) 100-4, Claims Processing, Chapter 13, Section 30:

30 – Computerized Axial Tomography (CT) Procedures (Rev. 1, 10-01-03)

“The TC RVUs for CT procedures that specify “with contrast” include payment for high osmolar contrast media. When separate payment is made for low osmolar contrast media under the conditions set forth in §30.1.1, reduce payment for the contrast media as set forth in §30.1.2.”

INDICATIONS AND USAGE | IMPORTANT SAFETY INFORMATION

CYSTOGRAFIN® (diatrizoate meglumine injection USP 30%)

and

CYSTOGRAFIN®-Dilute (diatrizoate meglumine injection USP 18%) 

Indications and Usage:

CYSTOGRAFIN® (diatrizoate meglumine injection USP 30%) and CYSTOGRAFIN®-Dilute (diatrizoate meglumine injection USP 18%) are indicated for retrograde cystourethrography and are not intended for intravascular injection.

IMPORTANT SAFETY INFORMATION:

Severe sensitivity reactions are more likely to occur in patients with a history of bronchial asthma, significant allergies, or previous reactions to contrast agents.

A history of sensitivity to iodine per se or to other contrast agents is not an absolute contraindication to the use of diatrizoate meglumine, but calls for extreme caution in administration.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see full Prescribing Information for CYSTOGRAFIN (diatrizoate meglumine injection USP 30%) by clicking here.

Please see full Prescribing Information for CYSTOGRAFIN-Dilute (diatrizoate meglumine injection USP 18%) by clicking here.

CYSTOGRAFIN is manufactured for Bracco Diagnostics Inc., Monroe Township, NJ 08831, by Patheon Italia S.p.A., Ferentino (Italy).

CYSTOGRAFIN is a registered trademark of Bracco Diagnostics Inc.