Urology Coding Alert

Question: Has there been another change to the codes I should be reporting for low osmolar contrast materials? Are A4644-A4646 still active?


Oklahoma Subscriber
Answer: Not anymore. As of April 1, 2005, there are new HCPCS codes for contrast agents. Instead of A4644-A4646 (Supply of low osmolar contrast material ...), report one of the following:
   Q9945 - Low osmolar contrast material, up to 149  mg/ml iodine concentration, per ml
   Q9946 - ... 150-199 mg/ml iodine concentration, per ml
   Q9947 - ... 200-249 mg/ml iodine concentration, per ml
   Q9948 - ... 250-299 mg/ml iodine concentration, per ml
   Q9949 - ... 300-349 mg/ml iodine concentration, per ml
   Q9950 - ... 350-399 mg/ml iodine concentration, per ml
   Q9951 - ... 400 or greater mg/ml iodine concentration, per ml. Don't miss: Like the old codes, the new codes are differentiated by quantity - and they're a lot more specific. For example, before April 1, you would code A4645 (... 200-299 mgs of iodine) for either 201 mg or 298 mg of iodine. Now, however, you would need to code Q9947 for 201 mg and Q9948 for 298 mg.

Important: Medicare specifies that "hospital outpatient departments shall continue to bill the A codes ... and shall not report [Q9945-Q9951]." To learn more about these changes, you can read a "Medlearn Matters" article at http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/MM3748.pdf.