A9604 Sm 153 lexidronam
Also known as: Quadramet, Sm-153, samarium therapy
Samarium Sm-153 lexidronam injection used therapeutically for treatment of metastatic bone pain.
In Plain Language
radioactive bone pain treatment; cancer pain therapy
Clinical Context
Used in targeted radiotherapy for palliative treatment of osteoblastic metastases and cancer-related bone pain.
RVU Information
CPT A9604 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.
Specialties
Frequently Asked Questions
What is CPT code A9604?
CPT A9604 (Sm 153 lexidronam) is a A Codes code. Samarium Sm-153 lexidronam injection used therapeutically for treatment of metastatic bone pain.
Does Medicare cover A9604?
Medicare coverage for A9604 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Used in targeted radiotherapy for palliative treatment of osteoblastic metastases and cancer-related bone pain. A physician order is typically required.
When is CPT A9604 used?
Used in targeted radiotherapy for palliative treatment of osteoblastic metastases and cancer-related bone pain.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.