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 |
|
|
A9588 |
Fluciclovine F-18, diagnostic, 1 millicurie, a PET imaging agent for detecting biochemical recurrence of prostate cancer |
|
|
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 |
|
|
Q9983* |
Florbetaben F18, diagnostic,per study dose, up to 8.1 millicuries |
*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.