A9611 HCPCS code: Flurpiridaz f 18, diagnostic, 1 millicurie
A9611 is the HCPCS Level II code for flurpiridaz f 18, diagnostic, 1 millicurie. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 13 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 | 57 |
| BETOS category | I1E |
| Added | 2025-04-01 |
| Last action effective | 2025-04-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 13 | Prescribing Information |
| practitioner claims | 13 | Prescribing Information |
Medicare policy articles for this code
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (635 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A18.84 | Tuberculosis of heart | 1 |
| C58 | Malignant neoplasm of placenta | 1 |
| C81.10 | Nodular sclerosis Hodgkin lymphoma, unspecified site | 1 |
| C81.11 | Nodular sclerosis Hodgkin lymphoma, lymph nodes of head, face, and neck | 1 |
| C81.12 | Nodular sclerosis Hodgkin lymphoma, intrathoracic lymph nodes | 1 |
| C81.13 | Nodular sclerosis Hodgkin lymphoma, intra-abdominal lymph nodes | 1 |
| C81.14 | Nodular sclerosis Hodgkin lymphoma, lymph nodes of axilla and upper limb | 1 |
| C81.15 | Nodular sclerosis Hodgkin lymphoma, lymph nodes of inguinal region and lower limb | 1 |
| C81.16 | Nodular sclerosis Hodgkin lymphoma, intrapelvic lymph nodes | 1 |
| C81.17 | Nodular sclerosis Hodgkin lymphoma, spleen | 1 |
Showing 10 of 635. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for A9611
- April 2025: Code appears in this HCPCS release
- 2025-04-01: A9611 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 A9611?
A9611 is the HCPCS Level II code for flurpiridaz f 18, diagnostic, 1 millicurie. Short descriptor: "Flurpiridaz f18, diag, 1 mci".
Does Medicare cover A9611?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for A9611?
Medicare policy articles that cite A9611 list 635 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include A18.84 (Tuberculosis of heart), C58 (Malignant neoplasm of placenta), C81.10 (Nodular sclerosis Hodgkin lymphoma, unspecified site). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of A9611 can be billed per day?
13 on outpatient hospital claims; 13 on practitioner claims (NCCI medically unlikely edits).
Related A96 codes
- A9600 — Strontium sr-89 chloride, therapeutic, per millicurie
- A9601 — Flortaucipir f 18 injection, diagnostic, 1 millicurie
- A9602 — Fluorodopa f-18, diagnostic, per millicurie
- A9603 — Injection, pafolacianine, 0.1 mg
- A9604 — Samarium sm-153 lexidronam, therapeutic, per treatment dose, up to 150 millicuries
- A9606 — Radium ra-223 dichloride, therapeutic, per microcurie
- A9607 — Lutetium lu 177 vipivotide tetraxetan, therapeutic, 1 millicurie
- A9608 — Flotufolastat f 18, diagnostic, 1 millicurie
- A9609 — Fludeoxyglucose f18 up to 15 millicuries
- A9610 — Xenon xe-129 hyperpolarized gas, diagnostic, per study dose
- A9612 — Injection, fluorescein, 1 mg
- A9615 — Injection, pegulicianine, 1 mg
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Next steps
- Run a reimbursement report for a device billed under A9611
- Watch A9611 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A9611
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.