December 31, 2016

HCPCS A9588 Created to Describe Fluciclovine F_18

The Centers for Medicare and Medicaid Services granted F-18 Fluciclovine an A-code and transitional pass-through status in the hospital setting effective Jan. 1, 2017.  Note that HCPCS code A9588, Fluciclovine f-18, diagnostic, 1 millicurie (mCi) is reported per 1 mCi - not per study dose.    

As of January 1, 2017, all local Medicare Administrative Contractors will cover F-18 Fluciclovine for its label indication.

F-18 Fluciclovine (Axumin™) injection is a diagnostic agent indicated for positron emission tomography imaging in men with suspected prostate cancer recurrence based on elevated blood prostate specific antigen levels following prior treatment. Please see www.axumin.comfor important safety information and full F-18 Fluciclovine prescribing information.

Other 2017 radiopharmaceutical changes include:

Additions:

HCPCS Code

Descriptor

Trade Name

A9515

Choline C-11, diagnostic,per study dose, up to 20 millicuries

Zevacoror

In-facility production

A9587

Gallium ga-68, dotatate, diagnostic, 0.1 millicurie a PET imaging agent for the localization of somatostatin receptor–positive neuroendocrine tumors

Netspot

A9588

Fluciclovine F-18, diagnostic, 1 millicurie, a PET imaging agent for detecting biochemical recurrence of prostate cancer

Axumin™

A9597

Positron emission tomography radiopharmaceutical, diagnostic, for tumor identification, not otherwise classified

 

A9598

Positron emission tomography radiopharmaceutical, diagnostic, for non-tumor identification, not otherwise classified

 

Q9982*

Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries

Vizamyl™

Q9983*

Florbetaben F18, diagnostic,per study dose, up to 8.1 millicuries

Neuraceq™

 

*HCPCS code C9458 and C9459 were deleted on June 30, 2016 and replaced with HCPCS code Q9982 (Flutemetamol F18, diagnostic, per study dose, up to 5 millicuries) and Q9983 (Florbetaben  f18, diagnostic, per study dose, up to 8.1 millicuries) effective July 1, 2016.