How To Use HCPCS Code C1734

HCPCS code C1734 describes an orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to-bone implantation. This code is used to identify a specific type of enteral support that is not otherwise classified. In this article, we will explore the details of HCPCS code C1734, 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 C1734?

HCPCS code C1734 is a specific code used to identify an orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to-bone implantation. This code is used to classify a particular type of enteral support that does not fall under any other specific category. It is important for medical coders to accurately assign this code to ensure proper documentation and billing.

2. Official Description

The official description of HCPCS code C1734 is “Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to-bone (implantable).” The short description for this code is “Enteral supp not otherwise c.” It is crucial to use the exact wording provided in the official description when assigning this code.

3. Procedure

1. Step 1: Prepare the patient for the orthopedic/device/drug matrix implantation procedure.
2. Step 2: Administer anesthesia to ensure the patient’s comfort and safety during the procedure.
3. Step 3: Make an incision at the appropriate site for the implantation.
4. Step 4: Carefully position and secure the orthopedic/device/drug matrix in the desired location.
5. Step 5: Close the incision using sutures or other appropriate closure methods.
6. Step 6: Provide post-operative care and instructions to the patient.

It is important for healthcare providers to follow the appropriate procedure guidelines and document each step accurately when using HCPCS code C1734.

4. When to use HCPCS code C1734

HCPCS code C1734 should be used when an orthopedic/device/drug matrix is being implanted to oppose bone-to-bone or soft tissue-to-bone. This code is specifically for implantable enteral support that does not fall under any other category. It is important to review the specific eligibility criteria and guidelines for using this code to ensure accurate documentation and billing.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1734, healthcare providers need to document the details of the procedure, including the specific orthopedic/device/drug matrix used and the location of the implantation. It is important to provide supporting documentation, such as operative reports, to justify the use of this code. Additionally, proper coding and billing guidelines should be followed to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1734 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an 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. It is important for medical coders to stay updated on any changes or revisions related to this code.

7. Medicare and Insurance Coverage

HCPCS code C1734 is subject to specific coverage instructions, as indicated by the coverage code D. This means that special coverage instructions apply when billing for this code. 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. It is important to review the Medicare Carriers Manual reference section number 2130 for additional information on coverage and pricing.

8. Examples

Here are five examples of when HCPCS code C1734 should be billed:

1. A patient undergoes a bone-to-bone orthopedic implantation using an orthopedic/device/drug matrix.
2. A soft tissue-to-bone implantation procedure is performed using an implantable enteral support matrix.
3. An opposing bone-to-bone implantation is carried out using a specific orthopedic/device/drug matrix.
4. A patient requires a soft tissue-to-bone orthopedic implantation using an implantable enteral support matrix.
5. An orthopedic/device/drug matrix is used for opposing bone-to-bone implantation in a complex surgical procedure.