Question 1

What is HCPCS code A9528?

Accepted Answer

HCPCS code A9528 is "Iodine i-131 iodide cap, dx". Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie

Question 2

What category is A9528 in?

Accepted Answer

A9528 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A9528?

Accepted Answer

Use A9528 when billing for iodine i-131 iodide cap, dx. 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 A9528 covered by Medicare?

Accepted Answer

Coverage for A9528 (Iodine i-131 iodide cap, dx) 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 A9528?

Accepted Answer

Documentation for A9528 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).