HCPCS Code Details - C1204

2017 HCPCS Level II Code
Temporary Codes for Use with Outpatient Prospective Payment System
HCPCS Code C1204
Description

Long description:
Technetium tc 99m tilmanocept, diagnostic, up to 0.5 millicuries

Short description:
Tc 99m tilmanocept

HCPCS Modifier1
HCPCS Pricing indicator 53 - Statute
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Statute number 1833(t)
Coverage code D - Special coverage instructions apply
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, 2014
Date added Oct 01, 2013
Termination date Dec 31, 2013
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

See also

  • HCPCS C1300 · Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval


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”