HCPCS A9575

Injection, gadoterate meglumine, 0.1 ml

HCPCS Code: A9575: The Healthcare Common Procedure Coding System (HCPCS) is a set of unique alphanumeric codes used to report medical procedures and services to healthcare programs like Medicare and Medicaid. HCPCS codes are used in conjunction with NDC codes for billing and medical documentation puporses. For instance, HCPCS A9575 identifies the type of service or supply used while any of the 14 NDC codes below could be used to specify the exact drug used.
Short Description: Inj gadoterate meglumi 0.1ml
Long Description: Injection, gadoterate meglumine, 0.1 ml
Pricing Indicator: Other carrier priced
Multiple Pricing Indicator: Not applicable as HCPCS priced under one methodology
Coverage Description: Carrier judgment
BETOS Type of Service: Standard imaging - nuclear medicine
Medicare Payment Limit: $0.12
Medicare Co-Insurance Percentage: 20.000%
HCPCS Classification: List of HCPCS codes for: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental (A-codes)

The NDC codes below allow precise billing based on the specific manufacturer and medication used:

NDC	Proprietary Name	Non-Proprietary Name	Dosage Form	Route Name	Company Name	Status
0407-2943	Clariscan	Gadoterate Meglumine	Injection, Solution	Intravenous	Ge Healthcare	ACTIVE
0407-2943	Clariscan	Gadoterate Meglumine	Injection, Solution	Intravenous	Ge Healthcare	ACTIVE
65219-080	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Fresenius Kabi Usa, Llc	ACTIVE
65219-082	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Fresenius Kabi Usa, Llc	ACTIVE
65219-084	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Fresenius Kabi Usa, Llc	ACTIVE
65219-086	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Fresenius Kabi Usa, Llc	ACTIVE
65219-088	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Fresenius Kabi Usa, Llc	ACTIVE
67684-2000	Dotarem	Gadoterate Meglumine	Injection	Intravenous	Guerbet Llc	ACTIVE
67684-2000	Dotarem	Gadoterate Meglumine	Injection	Intravenous	Guerbet Llc	ACTIVE
67684-2001	Dotarem	Gadoterate Meglumine	Injection	Intravenous	Guerbet Llc	ACTIVE
67684-2001	Dotarem	Gadoterate Meglumine	Injection	Intravenous	Guerbet Llc	ACTIVE
67684-3001	Dotarem	Gadoterate Meglumine	Injection	Intravenous	Guerbet Llc	ACTIVE
70436-123	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Slate Run Pharmaceuticals, Llc	ACTIVE
70436-123	Gadoterate Meglumine	Gadoterate Meglumine	Injection	Intravenous	Slate Run Pharmaceuticals, Llc	ACTIVE