How To Use HCPCS Code C1716

HCPCS code C1716 describes a brachytherapy source made of non-stranded gold-198. This code is used to identify and bill for the insertion of this specific type of brachytherapy source. In this article, we will explore the details of HCPCS code C1716, 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 C1716?

HCPCS code C1716 is used to identify a brachytherapy source made of non-stranded gold-198. Brachytherapy is a form of radiation therapy where a radioactive source is placed directly into or near the tumor site. The use of non-stranded gold-198 as a brachytherapy source allows for targeted radiation treatment.

2. Official Description

The official description of HCPCS code C1716 is “Brachytherapy source, non-stranded, gold-198, per source.” The short description is “Parenteral supp not othrws c.”

3. Procedure

1. The provider prepares the brachytherapy source made of non-stranded gold-198.
2. The provider inserts the brachytherapy source into or near the tumor site.
3. The provider ensures proper placement and positioning of the brachytherapy source.
4. The provider may use imaging techniques, such as ultrasound or fluoroscopy, to guide the insertion process.
5. The provider may secure the brachytherapy source in place using sutures or other techniques.
6. The provider removes any necessary protective coverings or packaging from the brachytherapy source.
7. The provider ensures patient comfort and safety during the procedure.

4. When to use HCPCS code C1716

HCPCS code C1716 should be used when a healthcare provider performs a brachytherapy procedure using a non-stranded gold-198 source. This code is specific to the use of this particular brachytherapy source and should not be used for other types of brachytherapy sources or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1716, healthcare providers should ensure that the procedure and use of the non-stranded gold-198 brachytherapy source are clearly documented in the patient’s medical record. The documentation should include details such as the site of the tumor, the method of insertion, and any imaging guidance used during the procedure. It is important to follow the specific billing guidelines and requirements of the payer, including any modifiers or additional documentation that may be necessary.

6. Historical information and Code Maintenance

HCPCS code C1716 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. The code has remained unchanged since its inception.

7. Medicare and Insurance Coverage

HCPCS code C1716 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 57 indicates that this code is priced by other carriers, meaning that the reimbursement rate may vary depending on the specific insurance plan. The multiple pricing indicator code A indicates that this code is not applicable as HCPCS priced under one methodology. Healthcare providers should verify coverage and reimbursement rates with the respective payer before performing the procedure.

8. Examples

Here are five examples of scenarios where HCPCS code C1716 should be billed:

1. A patient with prostate cancer undergoes brachytherapy using a non-stranded gold-198 source.
2. A patient with cervical cancer receives brachytherapy treatment with a non-stranded gold-198 source.
3. A patient with skin cancer undergoes brachytherapy using a non-stranded gold-198 source.
4. A patient with breast cancer receives brachytherapy treatment with a non-stranded gold-198 source.
5. A patient with lung cancer undergoes brachytherapy using a non-stranded gold-198 source.