How To Use HCPCS Code C1062

HCPCS code C1062 describes the procedure of intravertebral body fracture augmentation with implant, which can be made of metal or polymer materials. This code is used to identify and bill for the parenteral support provided during this procedure. In this article, we will explore the details of HCPCS code C1062, 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 C1062?

HCPCS code C1062 is used to identify the procedure of intravertebral body fracture augmentation with implant. This procedure involves the use of an implant, which can be made of metal or polymer, to stabilize and support a fractured vertebral body. The implant is inserted into the fractured area to provide structural support and promote healing. The parenteral support provided during this procedure is also included in this code.

2. Official Description

The official description of HCPCS code C1062 is “Intravertebral body fracture augmentation with implant (e.g., metal, polymer)”. The short description for this code is “Parenteral supp not othrws c”.

3. Procedure

1. The provider begins by preparing the patient for the procedure, ensuring that they are in the appropriate position and administering any necessary anesthesia.
2. An incision is made at the site of the fractured vertebral body, providing access to the affected area.
3. The fractured area is carefully cleaned and prepared for the implant.
4. The implant, which can be made of metal or polymer, is selected based on the specific needs of the patient and the fracture.
5. The implant is inserted into the fractured area, providing stability and support to the vertebral body.
6. Once the implant is in place, the incision is closed and the procedure is completed.

4. When to use HCPCS code C1062

HCPCS code C1062 should be used when performing the procedure of intravertebral body fracture augmentation with implant. This code is specifically for cases where an implant, made of metal or polymer, is used to stabilize and support a fractured vertebral body. It is important to ensure that the procedure meets the criteria outlined in the code description before using this code for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1062, healthcare providers should ensure that the necessary documentation is in place to support the procedure and the use of the implant. This may include documentation of the patient’s medical history, the specific details of the fracture, the selection and placement of the implant, and any additional services or supplies provided during the procedure. It is important to follow the billing guidelines set forth by the relevant payers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1062 was added to the Healthcare Common Procedure Coding System on January 01, 1985. 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 been in use since its addition and has not undergone any significant changes or revisions.

7. Medicare and Insurance Coverage

HCPCS code C1062 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 refer to the Medicare Carriers Manual Reference Section Number 2130, 4450 for specific guidance on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C1062 should be billed:

1. A 65-year-old patient with a vertebral compression fracture undergoes intravertebral body fracture augmentation with a metal implant.
2. A 50-year-old patient with osteoporosis experiences a vertebral body fracture and requires intravertebral body fracture augmentation with a polymer implant.
3. A 70-year-old patient with multiple vertebral fractures undergoes intravertebral body fracture augmentation with a combination of metal and polymer implants.
4. A 55-year-old patient involved in a car accident sustains a severe vertebral fracture and requires immediate intravertebral body fracture augmentation with a metal implant.
5. A 60-year-old patient with a history of spinal tumors undergoes intravertebral body fracture augmentation with a polymer implant to provide stability and support.