Table of content for "Mri hyperpolarized xenon129" (HCPCS C9791)
General information on the “C9791” code
HCPCS Code: C9791
Long Description: Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent, chest, including preparation and administration of agent
Short Description: Mri hyperpolarized xenon129
Original information is taken from C9791 page
Pricing indicators
Pricing Indicator Code 1: 53 – Statute
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: D – Special coverage instructions apply
Type of service
Berenson-Eggers Type of Service (BETOS): I2D – Advanced imaging - MRI/MRA: other
Type Of Service 1: 4 – Diagnostic radiology
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20231001
Code Effective Date: 20231001
Action Code: N – No maintenance for this code