MO HealthNet Division: Billing for Contrast Materials (Revised)

MO HealthNet regularly receives inquiries from hospitals regarding the correct codes to use for billing contrast materials such as those used for MRI and CAT scans performed in the hospital outpatient setting.

If the contrast material has a valid National Drug Code (NDC) associated with it, the hospital can bill the material either on the electronic outpatient UB-04 or the www.emomed.com Web site or the electronic institutional 837. The material can be billed also on the Pharmacy Claim Form on www.emomed.com.

If the material does not have a valid NDC or the NDC is alphanumeric, it can be billed with an appropriate HCPCS “A” code. Following is a list of the covered HCPCS “A” codes. These codes must be submitted either on a paper UB-04 or the electronic outpatient UB-04 on www.emomed.com. Regardless of which method is used to submit the claim, it must include an invoice of cost as the codes are manually priced.

A4641     A9512     A9536     A9548     A9561     A9577
A9500     A9516     A9537     A9550     A9562     A9578
A9501     A9517     A9538     A9551     A9563     A9579
A9502     A9521     A9539     A9552     A9564     A9580
A9503     A9524     A9540     A9553     A9566     A9581
A9504     A9526     A9541     A9554     A9567     A9582
A9505     A9527     A9542     A9555     A9568     A9583
A9507     A9528     A9543     A9556     A9569     A9600
A9508     A9529     A9544     A9557     A9570     A9698