2006 HCPCS RP Drugs

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                                       2006 HCPCS Level II Codes
      For Physician Office & Independent Diagnostic Testing Facilities
      Radiopharmaceuticals & Nuclear Medicine Related Drugs
                   Effective January 1, 2006
                                            CMS - Alpha-Numeric HCPCS CY 2006
                                         CMS Transmittal 738 CR 4053 November 1, 2005
                                                         CMS Web Site Drugs
  Indicator                          Description                                                                           Symbol
       E         Not paid under RBRVS                                                                   New Code          ●
                                                                                                                                    ■
       X         Not paid under RBRVS                                                                   Revised Code            ▲
The Centers for Medicare & Medicaid Services (CMS) introduced a new method to pay                       Cross Reference Cr Ref
physicians for drugs and biologicals in 2005 and this continues in 2006. This will be according         NOTE: Cross Reference Codes in this file may not
to a drug's average sales price (ASP) plus 6% or for some new drugs at wholesale acquisition            be direct, one to one, cross references. We
cost (WAC) plus 6% or established drugs at WAC . Additionally, CMS clarified in Transmittal             developed this list to assist SNM members in the
738 CR4053 that Radiopharmaceuticals are not subject to ASP. Contractors will determine                 conversion from many of the current RP HCPCS
radiopharmaceutical payment allowance limits based on the methodology in place as of                    level II codes to the 2006 code. Please check the
November 2003 which would allow invoice or AWP based pricing.                                           descriptions carefully in the 2006 code and be sure
                                                                                                        you have made adjustments in your pricing
To download the latest list of drugs and their ASP+6% prices, see the CMS Quarterly Drug
                                                                                                        consistent with the descriptions of the new and
File URL above. From there, scroll until you see the "ASP Pricing File" and click on this file.
                                                                                                        revised codes effective 2006.
CMS doesn’t classify drugs as physician services and they have no relative values. But CMS
pays for drugs at a rate of Average Sales Price (ASP) plus 6%.




    CPT/                                                                          Trade
                                                                            Relative                               ■
                                                                                                                  2005               RBRVS Payment            ASP Pricing
                                                                                                                                        Status                 File Rates
   HCPCS                             Description                            WeightName                         Cr Ref                                           1/1/2006
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
supply code(s), in addition to the procedure code.
                 Admin + supply, tositumomab, 450 mg                         Non Radioactive                       N/A                         X
   G3001         (Use this Code for Bexxar)                                  Bexxar®
  ▲ A4641        Radiopharm dx agent noc

                 RADIOPHARMACEUTICAL, DIAGNOSTIC,                                                                  N/A                         E
                 NOT OTHERWISE CLASSIFIED.




        Revised: January 1, 2006                              SNM Private Office Educational Material                                     Page 1 of 12
        CPT codes copyright by the AMA                                                                    Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                       Description                     WeightName                      Cr Ref                                  1/1/2006
  ▲ A4642 In111 satumomab
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE            ONCOSCINT®
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              INDIUM IN-111 SATUMOMAB                                                N/A             E
              PENDETIDE, DIAGNOSTIC, code.
supply code(s), in addition to the procedure PER STUDY
              DOSE, UP TO 6 MILLICURIES
 ▲ A9500     Tc99m sestamibi                                   CARDIOLITE® /
                                                               MIRALUMA®
             TECHNETIUM TC-99M SESTAMIBI,                                                       N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             40 MILLICURIES
 ▲ A9502     Tc99m tetrofosmin                 MYOVIEW®

             TECHNETIUM TC-99M TETROFOSMIN,                                                     N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             40 MILLICURIES
 ▲ A9503     Tc99m medronate                   MDP

             TECHNETIUM TC-99M MEDRONATE,                                                       N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             30 MILLICURIES
 ▲ A9504     Tc99m apcitide                                    ACUTECT®

             TECHNETIUM TC-99M APCITIDE,                                                        N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             20 MILLICURIES

 ▲ A9505     TL201 thallium                                    THALLIUM 201

             THALLIUM TL-201 THALLOUS                                                           N/A                     E
             CHLORIDE, DIAGNOSTIC, PER
             MILLICURIE
 ▲ A9507     In111 capromab                                    PROSTASCINT®

             INDIUM IN-111 CAPROMAB PENDETIDE,                                                  N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             10 MILLICURIES
 ▲ A9508     I131 iodobenguate, dx                             I-131 MIBG

             IODINE I-131 IOBENGUANE SULFATE,                                                   N/A                     E
             DIAGNOSTIC, PER 0.5 MILLICURIE
 ▲ A9510     Tc99m disofenin                                   DISIDA

             TECHNETIUM TC-99M DISOFENIN,                                                       N/A                     E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             15 MILLICURIES



      Revised: January 1, 2006                  SNM Private Office Educational Material                                   Page 2 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                      Description                      WeightName           Cr Ref                                             1/1/2006
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
   A9511      Technetium TC 99m depreotide                 NEOTEC®                ■
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                                                Cr Ref A9536
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              SUPPLY OF RADIOPHARMACEUTICAL
supply code(s), in addition toIMAGING AGENT,                                   changed to per Deleted 2006
              DIAGNOSTIC the procedure code.
              TECHNETIUM TC 99M DEPREOTIDE,                                      study dose
              PER MCI
  ▲ A9512 Tc99m pertechnetate                              Straight Tech
              TECHNETIUM TC-99M
              PERTECHNETATE, DIAGNOSTIC, PER                                         N/A             E
              MILLICURIE
   A9513     Technetium tc-99m mebrofenin                      CHOLETEC®                    ■

                                                                                          Cr Ref A9537
             SUPPLY OF RADIOPHARMACEUTICAL
             DIAGNOSTIC IMAGING AGENT,                                                    changed to per Deleted 2006
             TECHNETIUM TC-99M MEBROFENIN,                                                  study dose
             PER MCI
   A9514     Technetiumtc99mpyrophosphate                      PYROLITE®
                                                               *Use this code for   ■
             SUPPLY OF RADIOPHARMACEUTICAL                     myocardial infarct
             DIAGNOSTIC IMAGING AGENT,                         imaging. Do not    Cr Ref A9538
             TECHNETIUM TC-99M                                 use this code for changed to per Deleted 2006
             PYROPHOSPHATE, PER MCI                            GBP, RVG or         study dose
                                                               MUGA
                                                               procedures see
                                                               A9560
   A9515     Technetium tc-99m pentetate                       Tc-99m DTPA          ■

             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9539
             DIAGNOSTIC IMAGING AGENT,                                                    changed to per Deleted 2006
             TECHNETIUM TC-99M PENTETATE, PER                                               study dose
             MCI
 ▲ A9516     I123 iodide cap, dx                               Dx I-123
                                                               Capsules
             IODINE I-123 SODIUM IODIDE                                                         N/A                     E
             CAPSULE(S), DIAGNOSTIC, PER 100
             MICROCURIES
 ▲ A9517     I131 iodide cap, rx                               Rx I-131
                                                               Capsules
             IODINE I-131 SODIUM IODIDE                                                         N/A                     E
             CAPSULE(S), THERAPEUTIC, PER
             MILLICURIE




      Revised: January 1, 2006                  SNM Private Office Educational Material                                   Page 3 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                     Description                       WeightName                      Cr Ref                                  1/1/2006
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
   A9519      Technetiumtc-99mmacroag albu                 MAA                    ■
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                                                Cr Ref using
radiopharmaceuticals and drugs supplied by the physician should be reported separatelyA9540 the appropriate
              SUPPLY OF RADIOPHARMACEUTICAL
supply code(s), in addition toIMAGING AGENT,
              DIAGNOSTIC the procedure code.                                   changed to per Deleted 2006
              TECHNETIUM TC-99M                                                  study dose
              MACROAGGREGATED ALBUMIN, PER
              MCI
   A9520      Technetiumtc-99m sulfur clld                 SULFUR                 ■
                                                           COLLOID® (SC)
                                                                                Cr Ref A9541
              SUPPLY OF RADIOPHARMACEUTICAL
                                                                               changed to per Deleted 2006
              DIAGNOSTIC IMAGING AGENT,
              TECHNETIUM TC-99M SULFUR                                           study dose
              COLLOID, PER MCI
  ▲ A9521 Tc99m exametazime                                CERETEC®
                                                           HMPAO
              TECHNETIUM TC-99M EXAMETAZIME,                                         N/A            E
              DIAGNOSTIC, PER STUDY DOSE, UP TO
              25 MILLICURIES
                                                                                  ■
   A9522      Indium111ibritumomabtiuxetan                 Dx In-111
                                                           ZEVALIN®             Cr Ref A9542
              SUPPLY OF RADIOPHARMACEUTICAL                                    changed to per Deleted 2006
              DIAGNOSTIC IMAGING AGENT, INDIUM-                                  study dose
              111 IBRITUMOMAB TIUXETAN, PER MCI

   A9523     Yttrium90ibritumomabtiuxetan                      Rx Y-90                      ■
                                                               ZEVALIN®
                                                                                          Cr Ref A9543
             SUPPLY OF RADIOPHARMACEUTICAL
                                                                                          changed to per Deleted 2006
             THERAPEUTIC IMAGING AGENT,
                                                                                            study dose
             YTTRIUM 90 IBRITUMOMAB TIUXETAN,
             PER MCI
 ▲ A9524     I131 serum albumin, dx                            I-131 Albumin

             IODINE I-131 IODINATED SERUM                                                       N/A                     E
             ALBUMIN, DIAGNOSTIC, PER 5
             MICROCURIES
 ▲ A9526
             Nitrogen N-13 ammonia
                                                               N-13                             N/A                     E
             NITROGEN N-13 AMMONIA,
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             40 MILLICURIES
 ▲ A9528     Iodine I-131 iodide cap, dx

             IODINE I-131 SODIUM IODIDE                                                         N/A                     E
             CAPSULE(S), DIAGNOSTIC, PER                       I-131 Dx caps per
             MILLICURIE                                        mCi



      Revised: January 1, 2006                  SNM Private Office Educational Material                                   Page 4 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                      Description                      WeightName                      Cr Ref                                  1/1/2006
  ▲ A9529 I131 iodide sol, dx
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              IODINE I-131 SODIUM IODIDE                                             N/A             E
              SOLUTION, to the procedure code.
supply code(s), in addition DIAGNOSTIC, PER                Dx I-131 sol per
              MILLICURIE                                   mCi
  ▲ A9530 I131 iodide sol, rx

             IODINE I-131 SODIUM IODIDE                                                         N/A                     E
             SOLUTION, THERAPEUTIC, PER
             MILLICURIE                                        Rx I-131 sol per mCi
 ▲ A9531     I131 max 100uCi

             IODINE I-131 SODIUM IODIDE,                                                        N/A                     E
             DIAGNOSTIC, PER MICROCURIE (UP TO
                                               Dx I-131 up to
             100 MICROCURIES)
                                               100 uCi
 ▲ A9532     I125 serum albumin, dx
                                                                                                N/A                     E
             IODINE I-125 SERUM ALBUMIN,
             DIAGNOSTIC, PER 5 MICROCURIES
                                                                                            ■
   A9533     I-131 tositumomab diagnostic                      Dx BEXXAR®
                                                                                          Cr Ref A9544
             SUPPLY OF RADIOPHARMACEUTICAL                                                changed to per Deleted 2006
             DIAGNOSTIC IMAGING AGENT, I-131                                                study dose
             TOSITUMOMAB, PER MILLICURIE
                                                                                            ■
   A9534     I-131 tositumomab therapeut                       Rx BEXXAR®
                                                                                          Cr Ref A9545
             SUPPLY OF RADIOPHARMACEUTICAL                                                changed to per Deleted 2006
             THERAPEUTIC IMAGING AGENT, I-131                                               study dose
             TOSITUMOMAB, PER MILLICURIE
  ● A9535    Injection, methylene blue                         Used typically by
                                                               Surgeon for
             INJECTION, METHYLENE BLUE, 1 ML                   Sentinel Node
                                                               identification in OR         NEW 2006                    E
                                                               alternative to
                                                               Tc99m Filtered SC

  ● A9536    Tc99m depreotide                                  NEOTEC®                      ■

             TECHNETIUM TC-99M DEPREOTIDE,                                                Cr Ref A9511
                                                                                                                        E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             35 MILLICURIES
  ● A9537    Tc99m mebrofenin                                  CHOLETEC®                    ■

             TECHNETIUM TC-99M MEBROFENIN,                                                Cr Ref A9513
                                                                                                                        E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             15 MILLICURIES

      Revised: January 1, 2006                  SNM Private Office Educational Material                                   Page 5 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                       WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                            ■
                                                                                                 2005           RBRVS Payment        ASP Pricing
                                                                                                                   Status             File Rates
  HCPCS                      Description                      WeightName                        Cr Ref                                 1/1/2006
  ● A9538 Tc99m pyrophosphate
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE            PYROLITE® *Use
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                           this code for
                                                           myocardial infarct     ■
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              TECHNETIUM TC-99M
supply code(s), in addition to the procedure code. PER
              PYROPHOSPHATE, DIAGNOSTIC,                   imaging. Do not
                                                           use this code for    Cr Ref A9514
              STUDY DOSE, UP TO 25 MILLICURIES                                                       E
                                                           GBP, RVG or         Deleted in 2006
                                                               MUGA procedures
                                                               see A9560


  ● A9539    Tc99m pentetate                                   Tc-99m DTPA                   ■

             TECHNETIUM TC-99M PENTETATE,                                                 Cr Ref A9515
                                                                                                                         E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             25 MILLICURIES
  ● A9540    Tc99m MAA                                         MAA                           ■

             TECHNETIUM TC-99M                                                            Cr Ref A9519
             MACROAGGREGATED ALBUMIN,                                                                                    E
                                                                                          Deleted in 2006
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             10 MILLICURIES
  ● A9541    Tc99m sulfur colloid              SULFUR                                        ■
                                               COLLOID® (SC)
                                                                                          Cr Ref A9520
             TECHNETIUM TC-99M SULFUR                                                                                    E
             COLLOID, DIAGNOSTIC, PER STUDY                                               Deleted in 2006
             DOSE, UP TO 20 MILLICURIES
                                                                                            ■
  ● A9542    In111 ibritumomab, dx                             Dx In-111
                                                               ZEVALIN®                   Cr Ref A9522 &
             INDIUM IN-111 IBRITUMOMAB                                                    C1082 Deleted                  E
             TIUXETAN, DIAGNOSTIC, PER STUDY                                                 in 2006
             DOSE, UP TO 5 MILLICURIES
                                                                                            ■
  ● A9543    Y90 ibritumomab, rx                               Rx Y-90
                                                               ZEVALIN®                   Cr Ref A9523 &
             YTTRIUM Y-90 IBRITUMOMAB                                                     C1083 Deleted                  E
             TIUXETAN, THERAPEUTIC, PER                                                      in 2006
             TREATMENT DOSE, UP TO 40
                                                                                            ■
  ● A9544    MILLICURIES
             I131 tositumomab, dx                              Dx BEXXAR®
                                                                                          Cr Ref A9533 &
             IODINE I-131 TOSITUMOMAB,                                                    C1080 Deleted                  E
             DIAGNOSTIC, PER STUDY DOSE                                                       in 2006
                                                                                            ■
  ● A9545    I131 tositumomab, rx                              Rx BEXXAR®
                                                                                          Cr Ref A9534 &
             IODINE I-131 TOSITUMOMAB,                                                    C1081 Deleted                  E
             THERAPEUTIC, PER TREATMENT DOSE                                                 in 2006




      Revised: January 1, 2006                  SNM Private Office Educational Material                                    Page 6 of 12
      CPT codes copyright by the AMA                                                       Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                       WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                            ■
                                                                                                 2005           RBRVS Payment        ASP Pricing
                                                                                                                   Status             File Rates
  HCPCS                        Description                    WeightName                        Cr Ref                                 1/1/2006
  ● A9546 Co57/58
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE            NYCOMED
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              COBALT CO-57/58, CYANOCOBALAMIN,                                    NEW 2006           E
              DIAGNOSTIC, the procedure code.
supply code(s), in addition to PER STUDY DOSE, UP TO
              1 MICROCURIE
  ● A9547 In111 oxyquinoline                               Used with WBC
                                                           labeling
              INDIUM IN-111 OXYQUINOLINE,                                         NEW 2006           E
              DIAGNOSTIC, PER 0.5 MILLICURIE

  ● A9548    In111 pentetate                                   Indium DTPA

             INDIUM IN-111 PENTETATE,                                                        NEW 2006                    E
             DIAGNOSTIC, PER 0.5 MILLICURIE

  ● A9549    Tc99m arcitumomab                                 CEA-SCAN®

             TECHNETIUM TC-99M ARCITUMOMAB,                                                  NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             25 MILLICURIES
                                                                                            ■
  ● A9550    Tc99m gluceptate                  GLUCOSCAN®
                                                                                          Cr Ref C1200 &
             TECHNETIUM TC-99M SODIUM                                                      Q3006 Deleted                 E
             GLUCEPTATE, DIAGNOSTIC, PER                                                      in 2006
             STUDY DOSE, UP TO 25 MILLICURIES
  ● A9551    Tc99m succimer                                    DMSA

             TECHNETIUM TC-99M SUCCIMER,                                                     NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             10 MILLICURIES
  ● A9552    F18 fdg

             FLUORODEOXYGLUCOSE F-18 FDG,                                                    NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             45 MILLICURIES                    FDG / F-18
  ● A9553    Cr51 chromate

             CHROMIUM CR-51 SODIUM CHROMATE,                                                 NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             250 MICROCURIES
  ● A9554    I125 iothalamate, dx

             IODINE I-125 SODIUM IOTHALAMATE,                                                NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             10 MICROCURIES




      Revised: January 1, 2006                  SNM Private Office Educational Material                                    Page 7 of 12
      CPT codes copyright by the AMA                                                       Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                       WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                            ■
                                                                                                 2005           RBRVS Payment        ASP Pricing
                                                                                                                   Status             File Rates
  HCPCS                       Description                     WeightName           Cr Ref                                              1/1/2006
  ● A9555 Rb82 rubidium
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE                                   ■
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                                                Cr Ref using
radiopharmaceuticals andRB-82, supplied by the physician should be reported separatelyQ3000 the appropriate
              RUBIDIUM drugs DIAGNOSTIC, PER                                                        E
supply code(s), in addition to the procedure code.
              STUDY DOSE, UP TO 60 MILLICURIES                                 Deleted in 2006
                                                           Rb-82
  ● A9556 Ga67 gallium                                     GALLIUM                ■

                                                                                          Cr Ref Q3002
             GALLIUM GA-67 CITRATE, DIAGNOSTIC,                                                                          E
             PER MILLICURIE                                                               Deleted in 2006


  ● A9557    Tc99m bicisate                                    NEUROLITE®                    ■

                                                                                          Cr Ref Q3003
             TECHNETIUM TC-99M BICISATE,                                                                                 E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             25 MILLICURIES
  ● A9558    Xe133 xenon 10mci                 Xenon                                         ■

                                                                                          Cr Ref Q3004
             XENON XE-133 GAS, DIAGNOSTIC, PER                                                                           E
             10 MILLICURIES                                                               Deleted in 2006

                                                                                            ■
  ● A9559    Co57 cyano                                        Shillings Study
                                                                                          Cr Ref C9013 &
             COBALT CO-57 CYANOCOBALAMIN,                                                  Q3012 Deleted                 E
             ORAL, DIAGNOSTIC, PER STUDY DOSE,                                                in 2006
             UP TO 1 MICROCURIE
  ● A9560    Tc99m labeled rbc                 ULTRATAG® or
                                               Cold PYP + 99m
             TECHNETIUM TC-99M LABELED RED     Tc Code to be                                 ■
             BLOOD CELLS, DIAGNOSTIC, PER      used for both the
             STUDY DOSE, UP TO 30 MILLICURIES  invivo/invitro                             Cr Ref Q3010
                                                                                                                         E
                                               methods of                                 Deleted in 2006
                                               tagging Red
                                               Blood Cells

  ● A9561    Tc99m oxidronate                                  HDP®                          ■

                                                                                          Cr Ref Q3009
             TECHNETIUM TC-99M OXIDRONATE,                                                                               E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             30 MILLICURIES
  ● A9562    Tc99m mertiatide                  MAG-3®                                        ■

                                                                                          Cr Ref Q3005
             TECHNETIUM TC-99M MERTIATIDE,                                                                               E
             DIAGNOSTIC, PER STUDY DOSE, UP TO                                            Deleted in 2006
             15 MILLICURIES




      Revised: January 1, 2006                  SNM Private Office Educational Material                                    Page 8 of 12
      CPT codes copyright by the AMA                                                       Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                      Description                      WeightName           Cr Ref                                             1/1/2006
  ● A9563 P32 Na phosphate
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE                                   ■
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                                                Cr Ref using
radiopharmaceuticals and drugs supplied by the physician should be reported separatelyQ3007 the appropriate
              SODIUM PHOSPHATE P-32,                                                                E
supply code(s), in addition to the procedure code.
              THERAPEUTIC, PER MILLICURIE                                      Deleted in 2006


  ● A9564    P32 chromic phosphate                                                          ■

                                                                                          Cr Ref Q3011
             CHROMIC PHOSPHATE P-32                                                                                     E
             SUSPENSION, THERAPEUTIC, PER                                                 Deleted in 2006
             MILLICURIE
  ● A9565    In111 pentetreotide                               Octreoscan®                  ■

                                                                                          Cr Ref Q3008
             INDIUM IN-111 PENTETREOTIDE,                                                                               E
             DIAGNOSTIC, PER MILLICURIE                                                   Deleted in 2006


  ● A9566    Tc99m fanolesomab                                 NeutroSpec™

             TECHNETIUM TC-99M FANOLESOMAB,                                                 NEW 2006                    E
             DIAGNOSTIC, PER STUDY DOSE, UP TO
             25 MILLICURIES
  ● A9567    Technetium TC-99m aerosol         DTPA Aerosol
                                               For Lung
             TECHNETIUM TC-99M PENTETATE,      Ventilation                                  NEW 2006                    E
             DIAGNOSTIC, AEROSOL, PER STUDY    Studies
             DOSE, UP TO 75 MILLICURIES
 ▲ A9600     Sr89 strontium                    Rx
                                               METASTRON®
             STRONTIUM SR-89 CHLORIDE,                                                          N/A                     E
             THERAPEUTIC, PER MILLICURIE
 ▲ A9605     Sm 153 lexidronm                                  Rx
                                                               QUADRAMET®
             SAMARIUM SM-153 LEXIDRONAMM,                                                       N/A                     E
             THERAPEUTIC, PER 50 MILLICURIES
  ● A9698    Non-rad contrast material noc                     Non Radioactive
                                                               Contrast NOC
             NON-RADIOACTIVE CONTRAST                                                       NEW 2006                    E
             IMAGING MATERIAL, NOT OTHERWISE
             CLASSIFIED, PER STUDY
 ▲ A9699     Radiopharm rx agent noc                           RX NOC

             RADIOPHARMACEUTICAL,
                                                                                                N/A                     E
             THERAPEUTIC, NOT OTHERWISE
             CLASSIFIED




      Revised: January 1, 2006                  SNM Private Office Educational Material                                   Page 9 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                       WWW.SNM.ORG

   CPT/                                                              Trade
                                                               Relative                           ■
                                                                                                 2005           RBRVS Payment        ASP Pricing
                                                                                                                   Status             File Rates
  HCPCS                      Description                       WeightName                      Cr Ref                                  1/1/2006
              Injection NEW 2006 mg
NUCLEAR MEDICINE adenosine 6INTRODUCTORY LANGUAGE
    J0150
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              Injection Adenosine for therapeutic use, 6
              mg addition used to report any adenosine
supply code(s), in(not to beto the procedure code.                                   N/A             E
             phosphate compounds, instead use A9270)
                                                                                                                                     $       32.57
   J0151     Adenosine injection, 90 mg                                                    Deleted in 2005 Deleted 2006
   J0152     Adenosine injection, 30 mg                         ADENOCARD®

             Injection Adenosine for diagnostic use, 30
             mg (not to be used to report any adenosine                                          N/A                     E
             phosphate compounds, instead use A9270)

                                                                                                                                     $       70.30
   J0280     Aminophyllin up to 250 MG, inj.                                                     N/A                     E           $        0.40
   J0460     Atropine sulfate injection, up to 0.3 mg                                            N/A                     E           $        0.40
   J1120     Acetazolamide sodium injection, up to 500
                                                                                                 N/A                     E
             mg                                                 Diamox                                                               $       14.91
   J1160     Inj, digoxin, up to 0.5 mg                         Lanoxin                          N/A                     E           $        3.97
   J1245     Dipyridamole injection, per 10mg                   Persantine IV                    N/A                     E           $        1.68
   J1250     Inj dobutamine HCL/250 mg                          Dobutrex                         N/A                     E           $        5.02
  ● J1265    Dopamine injection
                                                                                             NEW 2006                    E
             INJECTION, DOPAMINE HCL, 40 MG                                                                                          $        0.71
   J1610     Glucagon hydrochloride per 1MG                                                      N/A                     E           $       65.96
   J1642     Inj heparin sodium per 10 units (hep lock
                                                                                                 N/A                     E
             flush)                                                                                                                          0.049
   J1800     Propranolol HCL injection, up to 1 mg              Inderal                          N/A                     E           $       4.55
   J1940     Furosemide injection up to 20 mg                   Lasix                            N/A                     E           $       0.38
   J2270     Morphine sulfate injection, up to 10 mg                                             N/A                     E           $       1.01
   J2271     Morphine sulfate injection, 100 mg                                                  N/A                     E           $       4.67
  ● J2805    Sincalide injection
                                                                                             NEW 2006                    E
             INJECTION, SINCALIDE, 5 MICROGRAMS Kinevac®                                                                             $       44.48
   J3240     Thyrotropin injection 0.9 mg n 1.1 mg vial
                                                                                                 N/A                     E
                                                        Thyrogen                                                                     $ 699.28
   J3490     Drugs Unclassified injection               NOC                                      N/A                     E
   J3590     Unclassified biologics                     NOC                                      N/A                     E
   J7030     Normal saline solution infus (1000 CC)                                              N/A                     E           $        0.90
   J7040     Normal saline solution infus (500ML=1)                                              N/A                     E           $        0.46
   J7050     Normal saline solution infus (250 CC)                                               N/A                     E           $        0.23
   J7051     Sterile saline/water
                                                                                           Deleted in 2006               E
             STERILE SALINE OR WATER, UP TO 5 CC
   J9310     Rituximab, 100 mg                                                                   N/A                     E
                                                                RituXan                                                              $ 462.90


      Revised: January 1, 2006                   SNM Private Office Educational Material                                 Page 10 of 12
      CPT codes copyright by the AMA                                                       Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                      Description                      WeightName                      Cr Ref                                  1/1/2006
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
   Q3000      Rubidium RB-82
                                                                                  ■
The services listed do not include the radiopharmaceutical or drug. Diagnostic and therapeutic
                                                                                Cr Ref using Deleted 2006
radiopharmaceuticals and drugs supplied by the physician should be reported separatelyA9555 the appropriate
              SUPPLY OF RADIOPHARMACEUTICAL
              DIAGNOSTIC the procedure code.
supply code(s), in addition toIMAGING AGENT,
              RUBIDIUM RB-82, PER DOSE                     Rb-82
   Q3002     Gallium ga 67                                     GALLIUM
                                                                                            ■
             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9556          Deleted 2006
             DIAGNOSTIC IMAGING AGENT, GALLIUM
             GA 67, PER MCI
   Q3003     Technetium tc99m bicisate                         NEUROLITE®
                                                                                            ■
             SUPPLY OF RADIOPHARMACEUTICAL
                                                                                          Cr Ref A9557          Deleted 2006
             DIAGNOSTIC IMAGING AGENT,
             TECHNETIUM TC99M BICISATE, PER
             UNIT DOSE
   Q3004     Xenon xe 133                                      Xenon
                                                                                            ■
             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9558          Deleted 2006
             DIAGNOSTIC IMAGING AGENT, XENON
             XE 133, PER 10 MCI
   Q3005     Technetium tc99m mertiatide                       MAG-3®
                                                                                            ■

                                                                                          Cr Ref A9562
             SUPPLY OF RADIOPHARMACEUTICAL                                                changed to per Deleted 2006
             DIAGNOSTIC IMAGING AGENT,                                                      study dose
             TECHNETIUM TC-99M MERTIATIDE, PER
             MCI
   Q3006     Technetium tc99m glucepatate                      GLUCOSCAN®                   ■

             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9550
             DIAGNOSTIC IMAGING AGENT,                                                    changed to per Deleted 2006
             TECHNETIUM TC 99M GLUCEPATATE,                                                 study dose
             PER 5 MCI

   Q3007     Sodium phosphate p32
                                                                                            ■
             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9563          Deleted 2006
             DIAGNOSTIC IMAGING AGENT, SODIUM
             PHOSPHATE P32, PER MCI




      Revised: January 1, 2006                  SNM Private Office Educational Material                                 Page 11 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.
      Compliments of the SNM                                                                                      WWW.SNM.ORG

   CPT/                                                             Trade
                                                              Relative                           ■
                                                                                                2005           RBRVS Payment        ASP Pricing
                                                                                                                  Status             File Rates
  HCPCS                      Description                      WeightName                      Cr Ref                                  1/1/2006
NUCLEAR MEDICINE NEW 2006 INTRODUCTORY LANGUAGE
   Q3008      Indium 111-in pentetreotide                  OCTREOSCAN®
The services listed do not include the radiopharmaceutical or drug. Diagnostic and■
                                                                                  therapeutic
radiopharmaceuticals and drugs supplied by the physician should be reported separately using the appropriate
              SUPPLY OF RADIOPHARMACEUTICAL                                     Cr Ref A9565 Deleted 2006
              DIAGNOSTIC the procedure code.
supply code(s), in addition toIMAGING AGENT, INDIUM
              111-IN PENTETREOTIDE, PER 3 MCI

   Q3009     Technetium tc99m oxidronate                       HDP®                         ■

             SUPPLY OF RADIOPHARMACEUTICAL                                                Cr Ref A9561
             DIAGNOSTIC IMAGING AGENT,                                                    changed to per Deleted 2006
             TECHNETIUM TC99M OXIDRONATE,                                                   study dose
             PER MCI
   Q3010     Technetium tc99mlabeledrbcs                       ULTRATAG® or
                                                               Cold PYP + 99m               ■
             SUPPLY OF RADIOPHARMACEUTICAL                     Tc Code to be
             DIAGNOSTIC IMAGING AGENT,                         used for both the          Cr Ref A9560
             TECHNETIUM TC99M - LABELED RED                    invivo/invitro             changed to per Deleted 2006
             BLOOD CELLS, PER MCI                              methods of                   study dose
                                                               tagging Red
                                                               Blood Cells

   Q3011     Chromic phosphate p32
                                                                                            ■
             SUPPLY OF RADIOPHARMACEUTICAL
             DIAGNOSTIC IMAGING AGENT,                                                    Cr Ref A9564          Deleted 2006
             CHROMIC PHOSPHATE P32
             SUSPENSION, PER MCI

   Q3012     Cyanocobalamin cobalt co57                                                     ■

             SUPPLY OF ORAL                                                               Cr Ref A9559
             RADIOPHARMACEUTICAL DIAGNOSTIC                                               changed to per Deleted 2006
             IMAGING AGENT, CYANOCOBALAMIN                                                  study dose
             COBALT CO57, PER 0.5 MCI




      Revised: January 1, 2006                  SNM Private Office Educational Material                                 Page 12 of 12
      CPT codes copyright by the AMA                                                      Prepared by Merlino Healthcare Consulting Corp.