How To Use HCPCS Code A9589

HCPCS code A9589 describes the procedure of instillation using hexaminolevulinate hydrochloride, with a dosage of 100 mg. This code is used to identify and bill for this specific procedure in medical coding and billing. In this article, we will explore the details of HCPCS code A9589, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS A9589?

HCPCS code A9589 is used to identify the procedure of instillation using hexaminolevulinate hydrochloride, with a dosage of 100 mg. This code specifically refers to the administration of hexaminolevulinate hydrochloride through instillation. It is important to note that HCPCS codes are used for reporting medical procedures and services for reimbursement purposes.

2. Official Description

The official description of HCPCS code A9589 is “Instillation, hexaminolevulinate hydrochloride, 100 mg.” The short description for this code is “Insti hexaminolevulinate hcl.” This description accurately represents the procedure and the substance used in the instillation process.

3. Procedure

1. The provider prepares the hexaminolevulinate hydrochloride solution with a dosage of 100 mg.
2. The provider ensures the patient is in a suitable position for the instillation procedure.
3. The provider inserts a catheter or other appropriate device into the relevant body cavity or organ.
4. The provider carefully instills the prepared hexaminolevulinate hydrochloride solution into the body cavity or organ.
5. The provider allows the solution to remain in the body cavity or organ for the specified duration.
6. The provider removes the catheter or device used for instillation.
7. The provider documents the procedure and any relevant findings or observations.

4. When to use HCPCS code A9589

HCPCS code A9589 should be used when the provider performs the instillation procedure using hexaminolevulinate hydrochloride with a dosage of 100 mg. This code is applicable in situations where the provider administers this specific substance through instillation. It is important to review the official description and guidelines for the code to ensure accurate usage.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code A9589, healthcare providers need to document the details of the procedure, including the dosage of hexaminolevulinate hydrochloride used, the body cavity or organ where the instillation was performed, and any relevant findings or observations. It is crucial to maintain accurate and detailed documentation to support the medical necessity of the procedure.

6. Historical Information and Code Maintenance

HCPCS code A9589 was added to the Healthcare Common Procedure Coding System on January 01, 2019. As of its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code is relatively new and has not undergone any significant changes or revisions since its addition.

7. Medicare and Insurance Coverage

The coverage and pricing of HCPCS code A9589 may vary depending on the specific insurance provider and Medicare guidelines. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology. It is important to verify the coverage and reimbursement policies of individual insurance plans and Medicare to determine the payment for this procedure.

8. Examples

Here are five examples of scenarios where HCPCS code A9589 should be billed:

1. A patient undergoes bladder instillation using hexaminolevulinate hydrochloride for the detection of bladder cancer.
2. A provider performs instillation of hexaminolevulinate hydrochloride into the uterine cavity for the evaluation of abnormal uterine bleeding.
3. A physician administers hexaminolevulinate hydrochloride through instillation into the renal pelvis for the assessment of renal abnormalities.
4. A urologist performs instillation of hexaminolevulinate hydrochloride into the urethra for the detection of urethral lesions.
5. A gastroenterologist administers hexaminolevulinate hydrochloride through instillation into the colon for the evaluation of colonic abnormalities.