How To Use HCPCS Code C1787

HCPCS code C1787 describes a patient programmer for a neurostimulator. This code is used to identify the specific device used to program and control a neurostimulator, which is a medical device that delivers electrical stimulation to specific nerves or areas of the body to help manage chronic pain or other conditions. In this article, we will explore the details of HCPCS code C1787, 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 C1787?

HCPCS code C1787 is used to identify a patient programmer for a neurostimulator. A patient programmer is a handheld device that allows the patient to adjust the settings of their neurostimulator, such as the intensity and frequency of the electrical stimulation. This device is an essential component of the neurostimulation therapy and plays a crucial role in the patient’s ability to manage their pain or other conditions effectively.

2. Official Description

The official description of HCPCS code C1787 is “Patient programmer, neurostimulator.” This description accurately reflects the purpose and function of the device.

3. Procedure

1. The provider will first assess the patient’s condition and determine if neurostimulation therapy is appropriate.
2. If neurostimulation therapy is deemed suitable, the provider will implant the neurostimulator device in the patient’s body. This involves a surgical procedure.
3. Once the neurostimulator is implanted, the provider will provide the patient with a patient programmer, which is coded as C1787.
4. The provider will instruct the patient on how to use the patient programmer to adjust the settings of their neurostimulator.
5. The patient will then be responsible for regularly using the patient programmer to manage their neurostimulation therapy.

4. When to use HCPCS code C1787

HCPCS code C1787 should be used when billing for the patient programmer device used in conjunction with a neurostimulator. It is important to note that this code is specific to neurostimulator therapy and should not be used for other types of devices or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1787, healthcare providers should ensure that the following documentation is included:

• Documentation supporting the medical necessity of neurostimulation therapy
• Documentation indicating the implantation of the neurostimulator device
• Documentation confirming the provision of the patient programmer device (HCPCS code C1787)

Providers should also follow the appropriate billing guidelines and coding rules set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1787 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 C1787 is eligible for coverage by Medicare and other insurance carriers. The pricing indicator code 57 indicates that the service or supply is priced by other carriers. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidance on coverage and reimbursement for HCPCS code C1787.

8. Examples

Here are five examples of when HCPCS code C1787 should be billed:

1. A patient with chronic back pain undergoes neurostimulation therapy. The provider implants a neurostimulator device and provides the patient with a patient programmer (HCPCS code C1787) to manage their pain.
2. A patient with peripheral neuropathy receives neurostimulation therapy. The provider implants a neurostimulator device and provides the patient with a patient programmer (HCPCS code C1787) to adjust the stimulation settings.
3. A patient with complex regional pain syndrome undergoes neurostimulation therapy. The provider implants a neurostimulator device and provides the patient with a patient programmer (HCPCS code C1787) for self-management of their condition.
4. A patient with failed back surgery syndrome receives neurostimulation therapy. The provider implants a neurostimulator device and provides the patient with a patient programmer (HCPCS code C1787) to customize their pain relief.
5. A patient with refractory angina undergoes neurostimulation therapy. The provider implants a neurostimulator device and provides the patient with a patient programmer (HCPCS code C1787) to adjust the therapy settings based on their symptoms.