PYLARIFY A Code: A9595
Piflufolastat f 18 (pylarify), diagnostic, 1 millicurie
Drug & Product Overview
About PYLARIFY
Pylarify is a medication aligned to the HCPCS A Code: A9595 for billing, pricing, and reimbursement purposes in the United States. It is an Imaging/Radiopharmaceutical drug administered via the intravenous route and manufactured by Progenics Pharmaceuticals, Inc.
Manufacturers, reach out to us to add more information.
NDC Code Information
2 NDC packages are crosswalked to A9595. Package detail is available to logged-in subscribers.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| •••••-••••-•• Log in to view | PYLARIFY | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | PYLARIFY | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
PYLARIFY Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Piflufolastat F-18 505(b)(2) Information:
| HCPCS Code | Manufacturer | Active Ingredient | HCPCS Description |
|---|---|---|---|
| A9595 | Progenics Pharmaceuticals, Inc | Piflufolastat F-18 | Piflufolastat f 18 (pylarify), diagnostic, 1 millicurie |
PYLARIFY CPT Administration Codes
The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.
| CPT Code | Description |
|---|---|
| 78811 | Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) |
| 78812 | Positron emission tomography (PET) imaging; skull base to mid-thigh |
| 78813 Login for More | Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; whole body. Login for More |
| 78814 Login for More | Tumor imaging, positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; whole body. Login for More |
| 78815 Login for More | Positron emission tomography (PET) with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization; skull base to mid-thigh. Login for More |
| 78816 Login for More | Positron emission tomography (PET) imaging; with concurrently acquired computed tomography (CT) for attenuation correction and anatomical localization, whole body. Login for More |
CMS does not include Pylarify (A9595) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing A9595. Wastage billing guide →
PYLARIFY Medically Unlikely Edits (MUE)
The most billing units of A9595 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 millicurie.
MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →
PYLARIFY Clinical Information
Indications and drug classification.
This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.
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Frequently Asked Questions
Is there an available Pylarify billing and coding guide?
Are there any available Pylarify patient assistance programs?
Where can I find Pylarify prescribing information?
Where can I find Pylarify side effect information?
Does billing PYLARIFY require JZ/JW wastage modifiers?
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