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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.

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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 codeShort descriptionModifier indicator
A9512Tc99m pertechnetate0 - no modifier bypassCheck 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 codeShort descriptionModifier indicator
78102Bone marrow imaging ltd0Check pair
78103Bone marrow imaging mult0Check pair
78104Bone marrow imaging body0Check pair
78122Whl bld volume determination0Check pair
78195Lymph system imaging0Check pair
78300Bone imaging limited area1Check pair
78305Bone imaging multiple areas1Check pair
78306Bone imaging whole body1Check pair
78315Bone imaging 3 phase0Check pair
78472Gated heart planar single0Check pair
78580Lung perfusion imaging0Check pair
78582Lung ventilat&perfus imaging0Check pair
78707K flow/funct image w/o drug0Check pair
78802Rp loclzj tum whbdy 1 d img1Check pair
78803Rp loclzj tum spect 1 area1Check 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.