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Q9967
Standard adult manual wheelchair used to improve mobility-related activities within the patient’s home.
Code Description
HCPCS code Q9967 describes the supply of a low osmolar iodinated contrast agent with an iodine concentration between 300 and 399 mg/mL. The code is billed per milliliter (mL) of contrast administered during eligible imaging procedures.
Low osmolar contrast agents improve visualization of blood vessels, organs, and other internal structures during diagnostic studies such as computed tomography (CT), angiography, and certain fluoroscopic examinations. These agents enhance image quality by increasing the radiographic density of targeted anatomy.
Q9967 represents only the contrast material itself. The imaging procedure, professional interpretation, catheterization services, and any separately reportable supplies should be billed using their appropriate CPT® or HCPCS codes when allowed by payer policy.
Because Q9967 is billed per milliliter, accurate documentation of the total volume administered is essential for proper reimbursement.
When to Use
Report Q9967 when a low osmolar iodinated contrast agent with an iodine concentration between 300 and 399 mg/mL is medically necessary for a covered diagnostic imaging procedure.
Common situations include contrast-enhanced CT examinations, CT angiography, diagnostic angiography, vascular imaging, and other radiologic procedures that require intravenous or intra-arterial iodinated contrast.
Only report the number of milliliters actually administered to the patient when payer guidelines permit separate reimbursement.
When NOT to Use
Do not report Q9967 when contrast material is packaged into the payment for the imaging service under payer policy.
Do not report this code for oral contrast agents, non-iodinated contrast materials, gadolinium-based MRI contrast agents, or contrast products with iodine concentrations that fall outside the code descriptor.
Do not bill for contrast that was prepared but not administered unless specifically allowed by payer policy.
Documentation Requirements
Documentation should clearly support both the medical necessity of contrast administration and the quantity billed.
The medical record should include the imaging procedure performed, the indication for contrast use, the specific contrast product administered, iodine concentration, total milliliters injected, route of administration, and any immediate adverse reactions or complications. Documentation should also identify the ordering provider and the interpreting physician when applicable.
Documentation Checklist
✔ Imaging study requiring contrast is documented
✔ Medical necessity supports contrast administration
✔ Contrast product is identified
✔ Iodine concentration is documented
✔ Total milliliters administered are recorded
✔ Route of administration is documented
✔ Units billed accurately reflect total mL administered
Billing Examples
CT Abdomen and Pelvis with Contrast
A patient undergoes a contrast-enhanced CT abdomen and pelvis using 100 mL of low osmolar iodinated contrast containing 350 mg/mL iodine concentration. Report 100 units of Q9967 if separately payable.
CT Angiography
A CT angiogram of the chest requires 75 mL of qualifying contrast material. Report 75 units of Q9967 when payer policy allows separate reimbursement.
Peripheral Angiography
A diagnostic angiography procedure uses 120 mL of qualifying contrast during vascular imaging. Bill 120 units of Q9967 when appropriate.
Coding & Billing Tips
Bill one unit for each milliliter administered.
Verify whether the payer separately reimburses contrast material.
Record the exact volume administered rather than estimating.
Confirm the iodine concentration matches the Q9967 code descriptor.
Maintain documentation supporting medical necessity.
Review National Correct Coding Initiative (NCCI) edits before billing concurrent imaging services.
Common Billing Mistakes
Billing More Units Than Administered
Because Q9967 is billed per milliliter, the number of units reported must equal the total volume of contrast actually administered. Billing more units than documented may result in denials, overpayment recoveries, or audits.
Selecting the Wrong HCPCS Contrast Code
Q9967 applies only to low osmolar iodinated contrast material with an iodine concentration of 300–399 mg/mL. Verify the product information before selecting the HCPCS code, as other concentrations are reported with different codes.
Reporting Q9967 When Contrast Is Packaged
Many payers package the cost of contrast material into the payment for the imaging procedure. Always verify payer-specific reimbursement policies before billing Q9967 separately.
Incomplete Administration Documentation
The medical record should identify the contrast product used, iodine concentration, total milliliters administered, route of administration, and the imaging procedure performed. Missing documentation may delay or prevent reimbursement.
Billing Prepared but Unused Contrast
Do not bill for contrast that was prepared but never administered unless payer policy specifically allows reimbursement for discarded amounts and all documentation requirements are met.
Applicable ICD-10-CM Diagnosis Codes
Diagnosis codes should accurately reflect the patient's documented condition and support medical necessity for contrast-enhanced imaging. The following examples are common indications but are not an all-inclusive list.
I26.99 – Other Pulmonary Embolism Without Acute Cor Pulmonale
This diagnosis code may support medical necessity when contrast-enhanced CT angiography is performed to evaluate or confirm a pulmonary embolism.
I71.4 – Abdominal Aortic Aneurysm, Without Rupture
This diagnosis code may support medical necessity when contrast-enhanced CT or angiography is performed to evaluate an abdominal aortic aneurysm.
C78.7 – Secondary Malignant Neoplasm of Liver and Intrahepatic Bile Duct
This diagnosis code may support medical necessity when contrast-enhanced imaging is performed to evaluate metastatic disease involving the liver.
Applicable Modifiers
Report Modifier JW when payer policy allows separate reporting of discarded amounts from a single-dose contrast container. Documentation should clearly identify the amount administered, the amount discarded, and compliance with payer requirements.
Report Modifier KX when payer policy requires confirmation that specific coverage criteria or medical necessity requirements have been met. Documentation should support that all applicable payer requirements have been satisfied.
Report Modifier 59 only when it is necessary to identify a distinct procedural service associated with the encounter and payer guidance supports its use. Documentation must clearly demonstrate that the service is separate and independently reportable.
Related HCPCS Codes
Q9965
Low osmolar contrast material with an iodine concentration of less than 240 mg/mL, reported per milliliter.
Q9966
Low osmolar contrast material with an iodine concentration of 240–299 mg/mL, reported per milliliter.
Q9968
Low osmolar contrast material with an iodine concentration of 400 mg/mL or greater, reported per milliliter.
Frequently Asked Questions
Can Q9967 be billed more than once during the same encounter?
Yes. Since Q9967 is reported per milliliter, the total number of units should equal the total volume of qualifying contrast material administered during the encounter, subject to payer guidelines.
Does Q9967 include the CT scan itself?
No. Q9967 represents only the contrast material. The imaging procedure, interpretation, and any other separately reportable services are billed using their appropriate CPT® or HCPCS codes.
How do I determine the correct HCPCS contrast code?
Review the manufacturer's product information and verify the iodine concentration. Q9967 is only appropriate for low osmolar iodinated contrast containing 300–399 mg/mL of iodine.
Can Q9967 be reported for MRI contrast?
No. Q9967 applies only to qualifying iodinated contrast material. Gadolinium-based contrast agents used for MRI are reported with different HCPCS codes.
What documentation is most commonly reviewed during an audit?
Auditors commonly verify the imaging procedure performed, medical necessity, the specific contrast product used, iodine concentration, total milliliters administered, and that the number of units billed matches the documented volume.
Category
HCPCS Level II
Common Setting
Billable Unit
Outpatient, imaging centers, physician offices
Per mL
Description
Code Type
HCPCS Code
Q9967
Low osmolar contrast material, 300–399 mg/mL iodine concentration, per mL
Radiology Supply
