How To Use HCPCS Code C8913

HCPCS code C8913 describes a specific medical procedure known as magnetic resonance angiography without contrast of the lower extremity. This code is used to identify and bill for this particular diagnostic imaging test. In this article, we will explore the details of HCPCS code C8913, 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 C8913?

HCPCS code C8913 is a specific code used in medical coding to identify and bill for magnetic resonance angiography without contrast of the lower extremity. This procedure involves the use of magnetic resonance imaging (MRI) technology to visualize the blood vessels in the lower extremities without the use of contrast agents. It provides valuable diagnostic information for evaluating vascular conditions and abnormalities in the lower limbs.

2. Official Description

The official description of HCPCS code C8913 is “Magnetic resonance angiography without contrast, lower extremity.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The patient is positioned on the MRI table, usually lying flat on their back.
2. The lower extremity to be examined is properly positioned within the MRI machine.
3. The MRI technician operates the machine and captures a series of images of the blood vessels in the lower extremity.
4. The images are then reviewed and interpreted by a radiologist or other qualified healthcare professional.
5. A report is generated based on the findings of the MRI angiography.

4. When to use HCPCS code C8913

HCPCS code C8913 should be used when performing magnetic resonance angiography without contrast of the lower extremity. This procedure is typically ordered by a healthcare provider to evaluate the blood vessels in the legs and feet for conditions such as peripheral artery disease, deep vein thrombosis, or other vascular abnormalities. It is important to ensure that the procedure is medically necessary and meets the specific criteria for coverage and reimbursement.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C8913, healthcare providers need to ensure that the necessary documentation is in place to support the medical necessity of the procedure. This may include the physician’s order, clinical notes, and the radiology report. It is also important to follow the specific billing guidelines set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C8913 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. This code has remained unchanged since its addition to the HCPCS.

7. Medicare and Insurance Coverage

Medicare and other insurance carriers may provide coverage for magnetic resonance angiography without contrast of the lower extremity when it is deemed medically necessary. The pricing indicator code for HCPCS code C8913 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 verify coverage and reimbursement policies with the specific insurance carrier to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code C8913 should be billed:

1. A patient with suspected peripheral artery disease undergoes magnetic resonance angiography without contrast of the lower extremity to evaluate blood flow and detect any blockages or narrowing in the leg arteries.
2. A patient with a history of deep vein thrombosis undergoes follow-up magnetic resonance angiography without contrast of the lower extremity to monitor the condition of the blood vessels and assess for any recurrent clotting.
3. A patient with chronic leg pain and swelling undergoes magnetic resonance angiography without contrast of the lower extremity to rule out any vascular abnormalities as the cause of their symptoms.
4. A patient with a suspected vascular malformation in the lower extremity undergoes magnetic resonance angiography without contrast to visualize the blood vessels and determine the extent and nature of the abnormality.
5. A patient with a suspected arterial occlusion in the lower extremity undergoes magnetic resonance angiography without contrast to assess the blood flow and identify the location and severity of the blockage.