A9569 Technetium tc-99m auto wbc
What A9569 is
Technetium tc-99m exametazime labeled autologous white blood cells, diagnostic, per study dose
HCPCS Level II long description, CMS October 2026 file. See the A codes page for the full section.
Medicare payment for A9569 (CY2026)
This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.
Medically Unlikely Edit (MUE)
Medicare caps A9569 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with A9569? These codes are bundled into it
A9569 is a Column 1 code in 1 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
A9512 | Tc99m pertechnetate | 0 - no modifier bypass | Check pair |
A9569 is bundled into these codes
A9569 appears as a Column 2 code in 15 active edits. Reported with one of these Column 1 codes on the same date of service, A9569 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
78102 | Bone marrow imaging ltd | 0 | Check pair |
78103 | Bone marrow imaging mult | 0 | Check pair |
78104 | Bone marrow imaging body | 0 | Check pair |
78122 | Whl bld volume determination | 0 | Check pair |
78195 | Lymph system imaging | 0 | Check pair |
78300 | Bone imaging limited area | 1 | Check pair |
78305 | Bone imaging multiple areas | 1 | Check pair |
78306 | Bone imaging whole body | 1 | Check pair |
78315 | Bone imaging 3 phase | 0 | Check pair |
78472 | Gated heart planar single | 0 | Check pair |
78580 | Lung perfusion imaging | 0 | Check pair |
78582 | Lung ventilat&perfus imaging | 0 | Check pair |
78707 | K flow/funct image w/o drug | 0 | Check pair |
78802 | Rp loclzj tum whbdy 1 d img | 1 | Check pair |
78803 | Rp loclzj tum spect 1 area | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.