How To Use HCPCS Code C1719

HCPCS code C1719 describes a specific type of brachytherapy source used in medical procedures. This code is used to identify a non-stranded, non-high dose rate iridium-192 source per source. In this article, we will explore the details of HCPCS code C1719, 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 C1719?

HCPCS code C1719 is used to identify a brachytherapy source that is non-stranded and non-high dose rate iridium-192. Brachytherapy is a type of radiation therapy where a radioactive source is placed directly into or near the tumor. This code specifically refers to the source used in the procedure.

2. Official Description

The official description of HCPCS code C1719 is “Brachytherapy source, non-stranded, non-high dose rate iridium-192, per source.” The short description is “Parenteral supp not othrws c.”

3. Procedure

1. The provider begins the procedure by preparing the brachytherapy source, ensuring it is non-stranded and non-high dose rate iridium-192.
2. The source is then inserted into or near the tumor site, using specialized equipment and techniques.
3. The provider ensures that the source is properly positioned and secured.
4. The source emits radiation, which targets and destroys cancer cells.
5. After the desired radiation dose is delivered, the source is removed from the patient.

4. When to use HCPCS code C1719

HCPCS code C1719 should be used when a non-stranded, non-high dose rate iridium-192 brachytherapy source is utilized in a medical procedure. It is important to ensure that the specific characteristics of the source match the description provided in the code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1719, healthcare providers need to document the use of the brachytherapy source and provide supporting documentation for medical necessity. It is important to include detailed information about the procedure, including the type of source used and any relevant clinical information.

6. Historical Information and Code Maintenance

HCPCS code C1719 was added to the Healthcare Common Procedure Coding System on January 01, 1985. As of the 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.

7. Medicare and Insurance Coverage

HCPCS code C1719 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 for specific guidelines on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code C1719 should be billed:

1. A patient with prostate cancer undergoes brachytherapy using a non-stranded, non-high dose rate iridium-192 source.
2. A patient with cervical cancer receives brachytherapy treatment with a non-stranded, non-high dose rate iridium-192 source.
3. A patient with skin cancer undergoes brachytherapy using a non-stranded, non-high dose rate iridium-192 source.
4. A patient with breast cancer receives brachytherapy treatment with a non-stranded, non-high dose rate iridium-192 source.
5. A patient with lung cancer undergoes brachytherapy using a non-stranded, non-high dose rate iridium-192 source.