How To Use HCPCS Code C1052

HCPCS code C1052 describes a hemostatic agent that is used topically in the gastrointestinal tract. This code is specifically for enteral supplementation that does not fall under any other category. In this article, we will explore the details of HCPCS code C1052, 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 C1052?

HCPCS code C1052 is used to identify a hemostatic agent that is applied topically in the gastrointestinal tract. It is specifically used for enteral supplementation that does not fall under any other category. This code is important for medical coders and billers to accurately document and bill for this particular service or supply.

2. Official Description

The official description of HCPCS code C1052 is “Hemostatic agent, gastrointestinal, topical.” The short description is “Enteral supp not otherwise c.” This description provides a clear understanding of the purpose and usage of this code.

3. Procedure

1. The procedure for HCPCS code C1052 involves the application of a hemostatic agent topically in the gastrointestinal tract.
2. The provider will identify the specific area in the gastrointestinal tract where the hemostatic agent needs to be applied.
3. The provider will prepare the hemostatic agent according to the manufacturer’s instructions.
4. The provider will apply the hemostatic agent directly to the identified area in the gastrointestinal tract.
5. The provider will ensure proper adherence and coverage of the hemostatic agent on the affected area.
6. The provider will monitor the patient for any adverse reactions or complications following the application of the hemostatic agent.

4. When to use HCPCS code C1052

HCPCS code C1052 should be used when a healthcare provider applies a hemostatic agent topically in the gastrointestinal tract for enteral supplementation purposes. It is important to ensure that the service or supply meets the specific criteria outlined in the code description to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1052, healthcare providers need to document the following:

• The medical necessity for using a hemostatic agent in the gastrointestinal tract
• The specific area in the gastrointestinal tract where the hemostatic agent was applied
• The quantity and dosage of the hemostatic agent used
• The patient’s response to the application of the hemostatic agent

Providers should also ensure that the documentation supports the medical necessity of the service or supply and includes any relevant clinical information.

6. Historical Information and Code Maintenance

HCPCS code C1052 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. 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 has remained unchanged since its addition to the system.

7. Medicare and Insurance Coverage

HCPCS code C1052 is covered by Medicare and other insurance carriers. 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, which means it is not applicable as HCPCS priced under one methodology. Providers should follow the specific guidelines and requirements of Medicare and other insurance carriers when billing for this service or supply.

8. Examples

Here are five examples of when HCPCS code C1052 should be billed:

1. A patient with gastrointestinal bleeding receives topical application of a hemostatic agent to control the bleeding.
2. A patient undergoing a gastrointestinal procedure requires enteral supplementation with a hemostatic agent to promote healing.
3. A patient with a gastrointestinal ulcer receives topical application of a hemostatic agent to aid in the healing process.
4. A patient with a gastrointestinal injury requires enteral supplementation with a hemostatic agent to prevent further bleeding.
5. A patient with a gastrointestinal tumor undergoes topical application of a hemostatic agent during a surgical procedure to minimize bleeding.