HCPCS Code Details - A9589

HCPCS Level II Code
Transportation Services Including Ambulance, Medical & Surgical Supplies
HCPCS Code A9589
Description

Long description:
Instillation, hexaminolevulinate hydrochloride, 100 mg

Short description:
Insti hexaminolevulinate hcl

HCPCS Modifier1
HCPCS Pricing indicator 57 - Other carrier priced
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
BETOS2 code I1E - Standard imaging - nuclear medicine
HCPCS Action code N - No maintenance for this code
Type of service 4 - Diagnostic radiology
Effective date Effective Jan 01, 2019
Date added Added Jan 01, 2019
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - A9589

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
April 1, 2024 - June 30, 2024 100 MG 1321.841 - - - - - -
January 1, 2024 - March 31, 2024 100 MG 1321.841 - - - - - -
October 1, 2023 - December 31, 2023 100 MG 1265.417 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 100 MG 1244.44 20% - - - - -
April 1, 2023 - June 30, 2023 100 MG 1244.44 20% - - - - -

See also

  • HCPCS A9588 · Fluciclovine f-18, diagnostic, 1 millicurie

  • HCPCS A9590 · Iodine i-131, iobenguane, 1 millicurie


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”