A4642 HCPCS code: Indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries
A4642 is the HCPCS Level II code for indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 1 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | A codes — Transportation, medical/surgical supplies and miscellaneous |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | I1E |
| Added | 1995-01-01 |
| Last action effective | 2006-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Code Descriptor / CPT Instruction |
| practitioner claims | 1 | Code Descriptor / CPT Instruction |
What changed for A4642
- 1995-01-01: A4642 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code A4642?
A4642 is the HCPCS Level II code for indium in-111 satumomab pendetide, diagnostic, per study dose, up to 6 millicuries. Short descriptor: "In111 satumomab".
Does Medicare cover A4642?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of A4642 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
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Next steps
- Run a reimbursement report for a device billed under A4642
- Watch A4642 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A4642
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.