Contrast Reimbursement and Purchasing
Reimbursement and Purchasing for Contrast Agents
If you have a question about reimbursement, please contact the Bayer Radiology Helpline at 1-800-423-7539.
- 2 mL = 20 units
- 7.5 mL = 75 units
- 10 mL = 100 units
- 15 mL = 150 units
- Enter the appropriate HCPCS code, A9581, Injection gadoxetate disodium, 1 mL in record locator 44 on the CMS 1450 Form
- Enter the mL quantity of Eovist that was administered to the patient. (Unlike for Gadavist, the Eovist HCPCS code unit of measure is 1.0 mL)
- Enter the appropriate HCPCS code for Eovist: A9581, Injection gadoxetate disodium, 1 mL
- Enter the mL quantity of Eovist that was administered to the patient. (Unlike for Gadavist, the Eovist HCPCS code unit of measure is 1.0 mL)
- J3490 (Injection, unclassified drugs)
- A9579 (Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified)
- C9399 (Unclassified drugs or biologicals) – applicable only for Medicare patients treated in a hospital outpatient setting
Please see Full Prescribing Information, including Boxed Warning, for Gadavist.
Please see Important Safety Information for Gadavist.
HCPCS code A9585 has been established by the Centers for Medicare and Medicaid Services (CMS) for Gadavist. CMS sought to assign a code which would allow for accurate billing of Gadavist presentations.
The code descriptor for A9585 Injection, gadobutrol, is per 0.1 mL. When billing it is important to note that the unit of measure for A9585 is 0.1 mL and Gadavist dosing is calculated by mL. When billing for the dose administered, you will need to multiply the HCPCS units by 10 to be reimbursed correctly. Examples:
Hospital-based outpatient HCPCS code for use with Gadavist.
Payer Type | Medicare | Other Payers |
|---|---|---|
HCPCS Code | A9585 | A9585 |
Code Description | Injection, Gadobutrol, per 0.1 mL | Injection, Gadobutrol, per 0.1 mL |
Freestanding HCPCS code for use with Gadavist.
HCPCS Code | Code Description |
|---|---|
A9585 | Injection, Gadobutrol, per 0.1 mL |
Note: Information provided in this resource is for informational purposes only and does not guarantee that codes will be appropriate or that coverage and reimbursement will result. Customers should consult with their payers for all relevant coverage, coding, and reimbursement requirements. It is the sole responsibility of the provider to select proper codes and ensure the accuracy of all claims used in seeking reimbursement. Neither this resource nor the Bayer Radiology Helpline is intended as legal advice or as a substitute for a provider's independent professional judgment.
HCPCS Code | Code Description | Possible Revenue Codes |
|---|---|---|
A9581 | Injection gadoxetate disodium, 1 mL | 636 |
When billing for Eovist for hospital outpatient services on or after January 1, 2010:
Freestanding Outpatient
HCPCS Code | Code Description |
|---|---|
A9581 | Injection gadoxetate disodium, 1 mL |
When billing for Eovist for freestanding outpatient services on or after January 1, 2010:
To avoid billing confusion, the use of Eovist should be noted on the patient's report dictated by the radiologist.
Note: These codes are provided for your information only. It is the responsibility of the provider to determine the most appropriate code to use in billing for services rendered. The use of these codes does not guarantee payment.
HCPCS Code | Code Description |
|---|---|
Q9966 | low osmolar contrast media (LOCM) 200-299 mg/mL iodine, per 1.0 mL |
Q9967 | low osmolar contrast media (LOCM) 300-399 mg/mL iodine, per 1.0 mL |
Please see Full Prescribing Information, including Boxed Warning, for Ambelvist.
Please see Important Safety Information for Ambelvist.
Procedures and contrast agents must be coded correctly in order to obtain appropriate reimbursement from both Centers for Medicare & Medicaid Services (CMS) and all other third-party payers.
A distinct Healthcare Common Procedure Coding System (HCPCS) code for Ambelvist is not yet available for use. During this period, a not-otherwise-classified (NOC) HCPCS code would be required when submitting a claim for reimbursement, along with additional information including: the National Drug Code (NDC) number, drug name, cost, and units.
Suggested NOC coding to report Ambelvist:
Please note that NOC drug codes always default to one unit whereas distinct HCPCS codes have units based on the dose administered, with each mL being one unit.
Additional coding information required for reimbursement would include Current procedural Terminology (CPT®) codes and International Classification of Diseases, Tenth Revision (ICD-10-CM) codes, among others potentially required by the payer.
If you have any questions about coding, coverage, or reimbursement, please contact the Bayer Radiology Reimbursement hotline to speak with a live agent (managed through The Pinnacle Health Group) at 1-800-423-7539 or BayerImaging@thepinnaclehealthgroup.com.
HCPCS Code | Code Description |
|---|---|
J3490 | (injection, unclassified drugs) |
A9579 | (injection, gadolinium based magnetic resonance contrast agent, not otherwise specified) |
C9399 Applicable only for Medicare patients treated in hospital outpatient setting | (unclassified drugs or biologicals) |
Click on links below for additional reimbursement resources for Ambelvist:
In today's cost-conscious healthcare environment, Bayer in Radiology offers a comprehensive line of quality imaging products at competitive prices combined with highly regarded service and support. Knowing that purchasers have unique requirements, we do our best to provide creative yet competitive contracts that go beyond just meeting product needs. Additional purchasing resources are described below.
Bayer in Radiology’s collaboration with McKesson Specialty 3rd Party Logistics (3PL) (1-877-259-4624) combines Bayer’s commitment to our customers with the drug distribution capabilities of McKesson. The benefits of purchasing through McKesson includes avoiding additional shipping charges and you may be eligible for a prompt pay discount of 2% when invoices are paid within 30 days.
Additional independent suppliers are listed below in alphabetical order.
Cencora (fka AmerisourceBergen) Valley Forge, PA 19087 610-727-7000 | Concordance HealthCare Solutions Tiffin, OH 44883 800-447-0225 | McKesson Pharma San Fransisco, CA 92123 800-811-9092 |
BlueRidge X-ray Company, Inc. Aden, NC 28704 828-681-9729 x139 | Freedom Imaging Anaheim, CA 82805 714-535-2520 x1 | Medline Industries Mundelein, IL 60060 847-949-5500 |
Cardinal Health, Inc. Dublin, OH 43017 866-551-0532 | Henry Schein, Inc. Melville NY 11747 800-772-4346 | Merry X-ray/Source One San Diego, CA 92123 800-635-9729 |
Cesar Catillo INC Guaynobo, PR 787-999-1616 | Jefferson Medical & Imaging, Inc. Oak Ridge, NJ 07438 973-697-5077 | Morris & Dickson Co., LLC Shreveport, LA 71115 318-797-7900 |
CMX Medical Imaging Tukwila, WA 78188 425-656-1269 | McKesson Medical Surgical Richmond, VA 23228 800-866-9243 | Owens & Minor, Inc. Mechanicsville, VA 23116 804-935-4180 |
Note: The Bayer in Radiology contrast and device products should be used in accordance with the Prescribing Information and Instructions For Use, respectively.