How To Use HCPCS Code C1728

HCPCS code C1728 describes a catheter used for brachytherapy seed administration. This code is specifically used for enteral supplies that do not fall under any other specific category. In this article, we will explore the details of HCPCS code C1728, including its official description, procedure, when to use it, billing guidelines, historical information, and coverage by Medicare and insurance providers.

1. What is HCPCS C1728?

HCPCS code C1728 is used to identify a catheter that is utilized for brachytherapy seed administration. Brachytherapy is a form of radiation therapy where radioactive seeds or sources are placed directly into or near the tumor site. This code is specifically used for enteral supplies that do not have a more specific code assigned to them. It is important to note that this code is not applicable for other types of catheters or procedures.

2. Official Description

The official description of HCPCS code C1728 is “Catheter, brachytherapy seed administration.” The short description for this code is “Enteral supp not otherwise c.” This description accurately represents the purpose and use of this specific catheter in the context of brachytherapy seed administration.

3. Procedure

1. The procedure for HCPCS code C1728 involves the insertion of the catheter into the patient’s body for the purpose of delivering brachytherapy seeds. The specific steps may vary depending on the patient’s condition and the location of the tumor.
2. The healthcare provider will first prepare the patient for the procedure, ensuring that the patient is in a comfortable position and adequately numbed or sedated, if necessary.
3. The provider will then locate the appropriate insertion site, which may be determined through imaging techniques such as ultrasound or CT scan.
4. Using sterile techniques, the provider will insert the catheter into the designated area, ensuring proper placement and securement.
5. Once the catheter is in place, the brachytherapy seeds will be administered through the catheter, either manually or with the assistance of specialized equipment.
6. After the seed administration is complete, the catheter may be removed or left in place, depending on the specific treatment plan.
7. Post-procedure care and monitoring will be provided to the patient to ensure proper healing and to address any potential complications.

4. When to use HCPCS code C1728

HCPCS code C1728 should be used when a healthcare provider is performing brachytherapy seed administration using a catheter. It is important to ensure that the procedure being performed aligns with the official description and purpose of this specific code. If the procedure involves a different type of catheter or a different administration method, a different HCPCS code should be used.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1728, healthcare providers should ensure that the necessary documentation is in place to support the use of this code. This may include medical records, procedure notes, and any relevant imaging or test results. It is important to accurately describe the procedure performed and provide any additional information required by the payer.

6. Historical Information and Code Maintenance

HCPCS code C1728 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition.

7. Medicare and Insurance Coverage

HCPCS code C1728 is covered by Medicare and other insurance providers. 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, indicating that 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 and instructions regarding coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code C1728 should be billed:

1. A patient with prostate cancer undergoes brachytherapy treatment using a catheter for seed administration.
2. A patient with cervical cancer receives brachytherapy seed administration via a catheter.
3. A healthcare provider performs brachytherapy seed administration using a catheter for a patient with lung cancer.
4. A patient with head and neck cancer undergoes brachytherapy treatment with the assistance of a catheter for seed administration.
5. A healthcare provider administers brachytherapy seeds through a catheter for a patient with gynecological cancer.