Ultrasound Question for the Week of February 6, 2017

Question:

Question:

How do we code for a contrast-enhanced liver ultrasound using LUMASON® (sulfur hexafluoride lipid-type A microspheres) for injectable suspension, for intravenous use or intravesical use?

Answer:

Answer:

If you are coding for a physician’s office or non-hospital imaging center you would report the current limited abdominal ultrasound code 76705 (or 76700 if a complete abdominal ultrasound was performed). In addition you would report Q9950 for the LUMASON® contrast agent. Q9950 should be reported per ml given. If you are billing for the outpatient hospital department (billing under OPPS), you would report HCPCS code C9744 – ultrasound, abdominal, with contrast – instead of 76705 or 76700. You would also report Q9950.

Medicare also allows you to bill for discarded amounts for single-use products, so you would bill Q9950 with the amount given one line, plus Q9950-JW with the discarded amount on a second line. Other payers may allow you to bill for the discarded amount, but you would need to check with your payers to confirm. Some payers may allow you to also report 96374 for the administration of LUMASON®.

LUMASON® (sulfur hexafluoride lipid-type A microspheres) for injectable suspension, for intravenous use or intravesical use

INDICATIONS AND USAGE1

LUMASON is an ultrasound contrast agent indicated for use:
• in echocardiography to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border in adult patients with suboptimal echocardiograms
• in ultrasonography of the liver for characterization of focal liver lesions in adult and pediatric patients
• in ultrasonography of the urinary tract for the evaluation of suspected or known vesicoureteral reflux in pediatric patients

CONTRAINDICATIONS1
LUMASON is contraindicated in patients with:
• history of hypersensitivity reactions to sulfur hexafluoride lipid microsphere components or to any of the inactive ingredients in LUMASON

IMPORTANT SAFETY INFORMATION1

WARNING: SERIOUS CARDIOPULMONARY REACTIONS

Serious cardiopulmonary reactions, including fatalities, have occurred uncommonly during or following the injection of ultrasound contrast agents, including sulfur hexafluoride lipid microspheres [see Warnings and Precautions (5.1)]. Most serious reactions occur within 30 minutes of administration [see Warnings and Precautions (5.1)].

• Assess all patients for the presence of any condition that precludes administration [see Contraindications (4)].
• Always have resuscitation equipment and trained personnel readily available [see Warnings and Precautions (5.1)].

The risk for serious cardiopulmonary reactions may be increased among patients with unstable cardiopulmonary conditions (acute myocardial infarction, acute coronary artery syndromes, worsening or unstable congestive heart failure, or serious ventricular arrhythmias) [see Warnings and Precautions (5.1)].1

Please see full Prescribing Information including boxed WARNING at http://www.braccoimaging.com/us-en/products-and-solutions/contrast-enhanced-ultrasound/lumason/prescribing-information

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

LUMASON is manufactured for Bracco Diagnostics Inc., Monroe Township, NJ 08831 by Bracco Suisse S.A., Plan-les-Ouates Geneve, Switzerland (LUMASON lyophilized powder vial-25 mg lipid-type A/60.7 sulfur hexafluoride gas); Vetter Pharma-Fertigung GmbH & Co. KG, 88212 Ravensburg, Germany (Sodium Chloride 0.9% Injection, USP); B. Braun Melsungen AG, 34212 Melsungen, Germany (Mini-Spike).

LUMASON is a registered trademark of Bracco Diagnostics Inc.