Question 1

What is HCPCS code A9542?

Accepted Answer

HCPCS code A9542 is "In111 ibritumomab, dx". Indium in-111 ibritumomab tiuxetan, diagnostic, per study dose, up to 5 millicuries

Question 2

What category is A9542 in?

Accepted Answer

A9542 belongs to HCPCS Category A (Transportation, Medical/Surgical Supplies, Miscellaneous).

Question 3

When should I use HCPCS code A9542?

Accepted Answer

Use A9542 when billing for in111 ibritumomab, 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 A9542 covered by Medicare?

Accepted Answer

Coverage for A9542 (In111 ibritumomab, 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 A9542?

Accepted Answer

Documentation for A9542 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).