How To Use HCPCS Code C1849

HCPCS code C1849 describes a skin substitute that is synthetic and resorbable, and is measured per square centimeter. This code is used to identify a specific type of medical supply or service provided by healthcare providers. In this article, we will explore the meaning and usage of HCPCS code C1849, as well as provide information on its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C1849?

HCPCS code C1849 is a unique code that is used to identify a specific medical supply or service. In this case, it refers to a skin substitute that is synthetic and resorbable, and is measured per square centimeter. This code is important for medical coders and billers to accurately document and bill for the use of this specific skin substitute.

2. Official Description

The official description of HCPCS code C1849 is “Skin substitute, synthetic, resorbable, per square centimeter.” This description provides a clear and concise explanation of the product or service that is being identified by this code. The short description for this code is “Enteral supp not otherwise c,” which further clarifies the nature of the skin substitute.

3. Procedure

1. Prepare the patient for the application of the skin substitute.
2. Cleanse and disinfect the area where the skin substitute will be applied.
3. Measure the size of the wound or area that needs coverage.
4. Cut the synthetic, resorbable skin substitute to the appropriate size.
5. Apply the skin substitute to the wound or area, ensuring proper coverage.
6. Secure the skin substitute in place using appropriate dressings or bandages.
7. Provide any necessary instructions to the patient for care and maintenance of the skin substitute.

4. When to use HCPCS code C1849

HCPCS code C1849 should be used when a healthcare provider utilizes a synthetic, resorbable skin substitute to cover a wound or area on a patient. This code is specific to the type of skin substitute being used and the method of measurement, which is per square centimeter. It is important to accurately document and bill for the use of this code when applicable.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1849, healthcare providers should ensure that the necessary documentation is in place to support the use of this code. This may include medical records, operative reports, or other relevant documentation that demonstrates the need for the skin substitute and the size of the area being covered. Additionally, providers should follow any specific billing guidelines or requirements set forth by Medicare or other insurance carriers.

6. Historical Information and Code Maintenance

HCPCS code C1849 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

Medicare and other insurance carriers may provide coverage for HCPCS code C1849, depending on the specific circumstances and guidelines. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for more information on coverage and reimbursement. It is important to understand the pricing indicator code and multiple pricing indicator code associated with this code to ensure accurate billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code C1849 should be billed:

1. A patient with a large burn injury requires the application of a synthetic, resorbable skin substitute to promote healing.
2. A patient undergoing reconstructive surgery needs a skin substitute to cover a surgical site and aid in the healing process.
3. A patient with a chronic wound that is not healing properly requires the use of a synthetic, resorbable skin substitute to facilitate healing.
4. A patient with a skin graft site needs a skin substitute to protect the graft and promote proper healing.
5. A patient with a non-healing ulcer requires the application of a synthetic, resorbable skin substitute to aid in the healing process.