How To Use HCPCS Code C1842

HCPCS code C1842 describes a retinal prosthesis, including all internal and external components, that is used as an add-on to HCPCS code C1841. This code is used to identify a specific medical device that is used in the treatment of retinal conditions. In this article, we will explore the details of HCPCS code C1842, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C1842?

HCPCS code C1842 is a specific code that is used to identify a retinal prosthesis, including all internal and external components. This code is an add-on to HCPCS code C1841, which represents the primary procedure or service. The retinal prosthesis is a medical device that is used to restore vision in individuals with retinal conditions. It is implanted in the eye and works by stimulating the remaining healthy cells in the retina to send visual signals to the brain.

2. Official Description

The official description of HCPCS code C1842 is “Retinal prosthesis, includes all internal and external components; add-on to C1841.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure for HCPCS code C1842 involves the implantation of a retinal prosthesis in the eye of the patient.
2. The patient is prepared for the procedure by administering local anesthesia to numb the eye.
3. An incision is made in the eye to create a small opening for the insertion of the retinal prosthesis.
4. The retinal prosthesis is carefully placed in the eye and positioned in the area of the retina that requires stimulation.
5. The incision is closed, and the patient is monitored for any complications or adverse reactions.

4. When to use HCPCS code C1842

HCPCS code C1842 should be used when a retinal prosthesis, including all internal and external components, is implanted as an add-on to the primary procedure or service represented by HCPCS code C1841. It is important to ensure that the patient meets the eligibility criteria for the use of this code and that the retinal prosthesis is medically necessary for their condition.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1842, healthcare providers need to document the medical necessity of the retinal prosthesis and provide supporting documentation, such as the patient’s medical history, diagnostic test results, and any other relevant information. It is also important to follow the billing guidelines set forth by Medicare or other insurance providers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1842 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. This code has a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology. 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 C1842 is eligible for coverage by Medicare and other insurance providers. The specific coverage instructions for this code may apply, as indicated by the coverage code D. Medicare and insurance providers determine the reimbursement amount for HCPCS code C1842 based on their pricing methodologies and fee schedules.

8. Examples

Here are five examples of when HCPCS code C1842 should be billed:

1. A patient with severe retinal degeneration undergoes a surgical procedure to implant a retinal prosthesis as an add-on to the primary procedure represented by HCPCS code C1841.
2. An individual with a history of retinal detachment receives a retinal prosthesis to restore vision in the affected eye.
3. A patient with a congenital retinal condition undergoes a retinal prosthesis implantation procedure to improve their visual function.
4. An elderly individual with age-related macular degeneration receives a retinal prosthesis to enhance their remaining vision.
5. A person who has lost their vision due to a traumatic eye injury undergoes a retinal prosthesis implantation procedure to regain visual perception.