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Reimbursement Billing for Indocyanine Green for Injection, USP

Diagnostic Green’s Indocyanine Green for Injection, USP is the
leading fluorescence product trusted by physicians,
to visualize fluorescence and guide their procedures.

Green wave in motion
Indications for Use and Supply

Indications for Use

The indications for Use for Indocyanine Green for Injection, USP are:
  • Determining Cardiac Output, Hepatic Function, and Liver Blood Flow
  • Ophthalmic Angiography

How it’s Supplied

Indocyanine Green for Injection USP is supplied in a kit (NDC 70100-424-02) containing six 25 mg Indocyanine Green for Injection USP vials and six 10 mL Sterile Water for Injection, USP plastic vials:
  • NDC 70100-424-01 Indocyanine Green for Injection USP vial 25 mg fill in 25 mL vial.
  • NDC 63323-185-10 (or NDC 0409-4887-17) Sterile Water for Injection, USP, 10 mL fill in 10 mL plastic vials.
Diagnostic Greens product

Procedure Codes

International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)

These procedure codes are used primarily to report hospital inpatient services. The International Society for Fluorescence Guided Surgery (ISFGS), has provided the following codes as a reference. When submitting a claim for a procedure using ICG, always verify coding requirements with the relevant payer. Coding requirements may vary by insurer or plan; please refer to the payer-specific policies to understand what codes may be covered. Check with the relevant payers regarding guidance on which diagnoses and procedures they will recognize. Health care professionals are solely responsible for selecting codes that appropriately reflect the patient’s diagnosis, the services rendered, and the applicable payer’s guidelines.

Codes effective from October 1, 2020

 
  • BF50200 Bile Duct, Indocyanine Green Dye, Intraoperative
  • BF53200 Bile Duct and Gallbladder, Indocyanine Green Dye, Intraoperative
  • BF52200 Gallbladder, Indocyanine Green Dye, Intraoperative
  • BF53200 Gallbladder and Bile Duct, Indocyanine Green Dye, Intraoperative
  • BF5C200 Hepatobiliary System, All, Indocyanine Green Dye, Intraoperative
  • BF55200 Liver, Indocyanine Green Dye, Intraoperative
  • BF56200 Spleen and Liver, Indocyanine Green Dye, Intraoperative
For more information click here
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Healthcare Common Procedure Coding System (HCPCS)

These codes are used in the following settings: physician offices, hospital outpatient departments (HOPDs), ambulatory surgical centers (ASCs), and by certain other providers.

  • Used to identify various items (pharmaceutical products and supplies) and some services
  • Many—not all—drugs and biologicals are reported with permanent J-codes
  • Drugs that are used exclusively in the inpatient setting generally will not receive a HCPCS code

Codes

  • C9733* Non-ophthalmic fluorescent vascular angiography
  • C9756* Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (List separately in addition to code for primary procedure)
  • Q9968*Injection, non-radioactive, non-contrast, visualization adjunct (eg., methylene blue, isosulfan blue), 1 mg

*Should not be billed with C9733 or C9756

For more information click here

Current Procedural Terminology (CPT)

These codes are used by physicians in all settings of care to report procedures.

  • 15860 Intravenous injection or agent (eg, fluorescein) test vascular flow in flap or agent
  • 47563 Bile Duct and Gallbladder, Indocyanine Green Dye, Intraoperative
  • 38900† Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)

†May only be reported with certain CPT codes CPT 2019, Professional Edition, American Medical Association

The information available in this guide is compiled from sources believed to be accurate, but the International Society for Fluorescence Guided Surgery (ISFGS) makes no representation that it is accurate. This information is subject to change. Payer coding requirements may vary or change over time, so it is important to regularly check with each payer regarding the payer-specific requirements. The information available here is not intended to be conclusive, nor is it intended to replace the guidance of a qualified professional advisor.
ISFGS and its agents make no warranties or guarantees, expressed or implied, concerning the accuracy or appropriateness of this information for your particular use given the frequent changes in public and private payer billing. The use of this information does not guarantee payment or that any payment received will cover your costs. You are solely responsible for determining the appropriate codes and for any action you take in billing. Consult the relevant payer manual and/or other guidelines for a description of each code to determine the appropriateness of a particular code and for information on additional codes. Diagnosis codes should be selected only by a health care professional.
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Current Codes Available

  • 4A12XSH Monitoring of Cardiac Vascular Perfusion using Indocyanine Green Dye, External Approach
  • 4A1GXSH Monitoring of Skin and Breast Vascular Perfusion using Indocyanine Green Dye, External Approach
  • 4A1BXSH Monitoring of Gastrointestinal Vascular Perfusion using Indocyanine Green Dye, External Approach
  • 4A1605H Monitoring of Lymphatic Flow using Indocyanine Green Dye, Open Approach
  • 4A1635H Monitoring of Lymphatic Flow using Indocyanine Green Dye, Percutaneous Approach
  • 4A1675H Monitoring of Lymphatic Flow using Indocyanine Green Dye, Via Natural or Artificial Opening
  • 4A1685H Monitoring of Lymphatic Flow using Indocyanine Green Dye, Via Natural or Artificial Opening Endoscopic
  • 8E090EZ Fluorescence guided procedure of head and neck region, open approach
  • 8E093EZ Fluorescence guided procedure of head and neck region, percutaneous approach
  • 8E094EZ Fluorescence guided procedure of head and neck region, percutaneous endoscopic approach
  • 8E097EZ Fluorescence guided procedure of head and neck region, via natural or artificial opening
  • 8E0W0EZ Fluorescence guided procedure of trunk region, open approach
  • 8E0W0EZ Fluorescence guided procedure of trunk region, percutaneous approach
  • 8E0W4EZ Fluorescence guided procedure of trunk region, percutaneous endoscopic approach

Appreciating the travel bans and cancellations of many public events around the world we want our customers to know that we will continue to supply ICG for your hospitals. Our supply chain is very robust and we manage our risk mitigation to ensure we maintain 100% fill rates. So, you can continue to plan and manage your patient procedures with confidence knowing our drug(s) will be available.

Thank you for your business,
Rick Manner
President