Radiopharmaceuticals and Contrast Media - …
Radiopharmaceuticals and Contrast Media Page 2 of 14 UnitedHealthcare Oxford Clinical Policy Effective 11/01/2021 ©1996-2021, Oxford Health Plans, LLC Code Code Description Allow with Procedure Codes 78451- 78454 78803 A9503 Technetium Tc-99m, Medronate, (MDP), diagnostic, per study dose, up to 30 mCi's 78300- 78315 78399 78803
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