| Short Descr | Gallium locametz 1 millicuri | Related Drugs | LOCAMETZ | Coverage | Carrier Priced | Pricing Indicator(s) | 57 – Other carrier priced | MPI | A – Not applicable, as HCPCS priced under one methodology | ASC Payment Group Code | YY – 10/01/2022 | BETOS | I1E – Standard imaging - nuclear medicine | TOS Code(s) | 4 – Diagnostic radiology | Added Date | 10/1/2022 | Status Code | Statutory Exclusion (from MPFS, may be paid under other methodologies) | Global Days | XXX - Global Concept Does Not Apply | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Pass-Through Drugs and Biologicals | ASC Payment Indicator | Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | MUE | 7 | MUE | Not applicable/unspecified. | OTS Orthotic | No |
| X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | JZ | Zero drug amount discarded/not administered to any patient | GA | Waiver of liability statement issued as required by payer policy, individual case | JW | Drug amount discarded/not administered to any patient | KX | Requirements specified in the medical policy have been met |
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Date
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Action
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Notes
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| 2023-01-01 | Added | First appearance in codebook. |
| 2022-10-01 | Added | Code added. |