How To Use HCPCS Code C1788

HCPCS code C1788 describes an indwelling port that is implantable and used for enteral support. This code is used to identify and bill for the specific device used in enteral support procedures. In this article, we will explore the details of HCPCS code C1788, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS C1788?

HCPCS code C1788 is used to identify an indwelling port that is implantable and utilized for enteral support. This code specifically refers to the device used in enteral support procedures and is not applicable to other types of procedures or supplies.

2. Official Description

The official description of HCPCS code C1788 is “Port, indwelling (implantable).” The short description for this code is “Enteral supp not otherwise c.” This description accurately represents the purpose and use of the code.

3. Procedure

1. The provider begins by preparing the patient for the procedure, ensuring their comfort and safety.
2. Anesthesia may be administered to the patient, depending on the specific circumstances and the patient’s needs.
3. A small incision is made in the appropriate area to access the site where the indwelling port will be implanted.
4. The port is carefully inserted into the incision site and secured in place.
5. The incision is closed using sutures or other appropriate closure methods.
6. Post-procedure care and monitoring are provided to ensure the patient’s well-being and to address any potential complications.

4. When to use HCPCS code C1788

HCPCS code C1788 should be used when an indwelling port is implanted for enteral support procedures. It is important to ensure that the specific criteria for using this code are met, as outlined by the relevant coding guidelines and documentation requirements.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1788, healthcare providers must ensure that the necessary documentation is completed accurately and thoroughly. This documentation should include details about the procedure, the medical necessity of the indwelling port, and any relevant patient information. Additionally, providers should follow the appropriate billing guidelines and submit the claim with the correct codes and modifiers as required by the payer.

6. Historical Information and Code Maintenance

HCPCS code C1788 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. It is important to note that this code has been in use for a significant period, indicating its established role in enteral support procedures.

7. Medicare and Insurance Coverage

HCPCS code C1788 is subject to coverage 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 consult the Medicare Carriers Manual Reference Section Number 2130 for further guidance on coverage and reimbursement for this code.

8. Examples

Here are five examples of scenarios where HCPCS code C1788 would be billed:

1. A patient with a chronic gastrointestinal condition requires enteral support and undergoes the implantation of an indwelling port for long-term access to enteral nutrition.
2. An individual with a severe swallowing disorder requires enteral support and receives an indwelling port to facilitate the administration of liquid nutrition.
3. A patient with a history of malabsorption issues undergoes the implantation of an indwelling port to ensure adequate enteral support and nutrient absorption.
4. An individual with a congenital anomaly affecting their digestive system requires long-term enteral support and receives an indwelling port for the administration of specialized enteral formulas.
5. A patient undergoing treatment for cancer requires enteral support and receives an indwelling port to facilitate the administration of chemotherapy-related nutrition.