A9528, Iodine i-131 sodium iodide capsule(s), diagnostic, per millicurie
HCPCS/CPT
Prior Authorization
Prior Auth Required
Code explicitly requires prior authorization (high confidence)
Medicare Pricing
Work RVU
0.00
Facility
N/A
Non-Facility
N/A
Key Coverage Criteria
- Indication: Strontium-89 is medically necessary for symptomatic bone metastases when both: (1) Confirmed osteoblastic bone metastases from solid organ cancer; (2) Pain not adequately controlled by conventional therapy.
2 Active Policies
CARELON-theranostics-therapeutic-radiopharmaceuticals-2026-04-04, Theranostics Therapeutic Radiopharmaceuticals
EVICORE-HPLAN-CIGNA_MEDICARE-68F4526A04BF, 1199SEIU Radiology and Cardiology Claims Studio Code List - Effective 01/01/2026
Related Codes
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