| HCPCS Code: |
A4642 |
| Long Description: |
Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries |
| Short Description: |
In111 satumomab |
| Pricing Indicator 1: |
51 (Drugs) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
|
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
I1E (Standard imaging - nuclear medicine) |
| Type of Service Code 1: |
4 (Diagnostic radiology) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1995 |
| Action Effective Date: |
01-01-2006 |
| Action Code: |
N (No maintenance for this code) |
