How To Use HCPCS Code C1602

HCPCS code C1602 describes an orthopedic/device/drug matrix/absorbable bone void filler that is antimicrobial-eluting and implantable. This code is used to identify a specific type of parenteral support that is not otherwise classified. In this article, we will explore the details of HCPCS code C1602, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS C1602?

HCPCS code C1602 is a unique alphanumeric code that is used to identify a specific medical supply or service. In this case, it represents an orthopedic/device/drug matrix/absorbable bone void filler that is antimicrobial-eluting and implantable. This code is used to classify a particular type of parenteral support that is not otherwise classified under any other HCPCS code.

2. Official Description

The official description of HCPCS code C1602 is “Orthopedic/device/drug matrix/absorbable bone void filler, antimicrobial-eluting (implantable)”. The short description for this code is “Parenteral supp not othrws c”. These descriptions provide a concise summary of the specific medical supply or service that is represented by this code.

3. Procedure

1. Prepare the patient for the procedure, ensuring proper positioning and anesthesia, if necessary.
2. Access the surgical site and remove any damaged or diseased tissue.
3. Prepare the orthopedic/device/drug matrix/absorbable bone void filler according to the manufacturer’s instructions.
4. Implant the antimicrobial-eluting bone void filler into the bone defect or void.
5. Close the surgical site and provide appropriate post-operative care.

The procedure for HCPCS code C1602 involves the implantation of an antimicrobial-eluting bone void filler to address bone defects or voids. It is important for healthcare providers to follow the specific steps and guidelines for this procedure to ensure optimal patient outcomes.

4. When to use HCPCS code C1602

HCPCS code C1602 should be used when providing orthopedic treatment that involves the use of an antimicrobial-eluting bone void filler. This code is specifically intended for cases where other HCPCS codes do not adequately capture the nature of the procedure or supply being used. It is important to review the specific eligibility criteria and guidelines for using this code to ensure accurate billing and documentation.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1602, healthcare providers need to ensure that they accurately document the details of the procedure and supply provided. This includes documenting the specific bone defect or void being addressed, the type and brand of the antimicrobial-eluting bone void filler used, and any other relevant information. It is also important to follow the billing guidelines and requirements set forth by Medicare and other insurance providers to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1602 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since 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. It is important to note that this code has an effective date of January 01, 1996, and has been priced by other carriers using the pricing indicator code 57, which indicates that it is priced by carriers other than Medicare. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology.

7. Medicare and Insurance Coverage

HCPCS code C1602 is eligible for coverage by Medicare and other insurance providers. However, it is important to review the specific coverage policies and guidelines set forth by each individual payer. The pricing indicator code 57 indicates that this code is priced by other carriers, and the Medicare Carriers Manual Reference Section Number 2130 provides additional information on how this code is priced and reimbursed by Medicare.

8. Examples

Here are five examples of when HCPCS code C1602 should be billed:

1. A patient undergoes orthopedic surgery to address a bone defect in their tibia. During the procedure, an antimicrobial-eluting bone void filler is implanted to promote bone regeneration.
2. A patient with a history of osteomyelitis requires treatment for a bone void in their femur. An orthopedic surgeon uses an antimicrobial-eluting bone void filler to fill the void and prevent infection.
3. A patient undergoes a spinal fusion procedure to address a vertebral defect. As part of the procedure, an antimicrobial-eluting bone void filler is used to promote fusion and prevent infection.
4. A patient with a bone defect in their mandible undergoes reconstructive surgery. An antimicrobial-eluting bone void filler is used during the procedure to support bone regeneration and prevent infection.
5. A patient with a non-healing bone fracture undergoes a bone graft procedure. An antimicrobial-eluting bone void filler is used to fill the void and promote healing.