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Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries

HCPCS code

Medical Policies and Guidelines for Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries

Related policies from health plans

Radioimmunotherapy and Somatostatin Receptor Targeted Radiotherapy

Similar Codes


ICD10CM codes

Z51.12 - Encounter for antineoplastic immunotherapy
Z51.1 - Encounter for antineoplastic chemotherapy and immunotherapy
Z92.850 - Personal history of Chimeric Antigen Receptor T-cell therapy
Z29.1 - Encounter for prophylactic immunotherapy
Z92.22 - Personal history of monoclonal drug therapy
Z51.0 - Encounter for antineoplastic radiation therapy
Z51.11 - Encounter for antineoplastic chemotherapy
C93.01 - Acute monoblastic/monocytic leukemia, in remission
C94.21 - Acute megakaryoblastic leukemia, in remission
C93.Z1 - Other monocytic leukemia, in remission

HCPCS codes

A9543 - Yttrium y-90 ibritumomab tiuxetan, therapeutic, per treatment dose, up to 40 millicuries
A9568 - Technetium tc-99m arcitumomab, diagnostic, per study dose, up to 45 millicuries
A9562 - Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries
A9520 - Technetium tc-99m tilmanocept, diagnostic, up to 0.5 millicuries
A9557 - Technetium tc-99m bicisate, diagnostic, per study dose, up to 25 millicuries
A9521 - Technetium tc-99m exametazime, diagnostic, per study dose, up to 25 millicuries
A9539 - Technetium tc-99m pentetate, diagnostic, per study dose, up to 25 millicuries
A9551 - Technetium tc-99m succimer, diagnostic, per study dose, up to 10 millicuries
A9604 - Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
A9561 - Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries

CPT4 codes

79403 - Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion
96405 - Chemotherapy administration; intralesional, up to and including 7 lesions
96413 - Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substan
96402 - Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic
96401 - Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
86945 - Irradiation of blood product, each unit
0395T - High dose rate electronic brachytherapy, interstitial or intracavitary treatment, per fraction, incl
90284 - Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each
77470 - Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitar
80280 - Vedolizumab