Ultrasound Question for the Week of May 2, 2016

Question:

Question:

What HCPCS code would I use for LUMASON® (sulfur hexafluoride lipid-type A microspheres) for injectable suspension?  I’ve been told three different codes and I’m confused.

Answer:

Answer:

Your confusion is understandable.  Since the FDA approved LUMASON for use in the U.S., the appropriate billing code has changed from non-specific code, to a “C” code, to a “Q” code in 2015.  

As of January 1, 2016, the correct code regardless of facility type is Q9950 – Injection, sulfur hexafluoride lipid microspheres, per mL.   

For outpatient hospital claims from 10/1/2015 – 12/31/2015, LUMASON was coded C9457 – Injection, sulfur hexafluoride lipid microsphere, per mL.