How To Use HCPCS Code C8935

HCPCS code C8935 describes a specific medical procedure known as magnetic resonance angiography without contrast for the upper extremity. This code is used to identify and bill for this particular diagnostic imaging test. In this article, we will delve into the details of HCPCS code C8935, 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 C8935?

HCPCS code C8935 is a specific code used to identify the medical procedure of magnetic resonance angiography without contrast for the upper extremity. This procedure involves the use of magnetic resonance imaging (MRI) technology to visualize the blood vessels in the upper extremity without the use of contrast agents. It is a non-invasive diagnostic test that provides detailed images of the blood vessels, helping healthcare providers diagnose and evaluate conditions such as arterial stenosis, aneurysms, and vascular malformations in the upper extremity.

2. Official Description

The official description of HCPCS code C8935 is “Magnetic resonance angiography without contrast, upper extremity.” The short description for this code is “Parenteral supp not othrws c.” This description accurately reflects the specific procedure and its purpose.

3. Procedure

1. The procedure for HCPCS code C8935 involves the use of magnetic resonance imaging (MRI) technology.
2. Prior to the procedure, the patient will be positioned on the MRI table, usually lying on their back.
3. The upper extremity, which includes the arm, shoulder, and surrounding area, will be positioned within the MRI machine.
4. The MRI machine uses a strong magnetic field and radio waves to create detailed images of the blood vessels in the upper extremity.
5. The procedure does not involve the use of contrast agents, which are substances injected into the bloodstream to enhance the visibility of blood vessels.
6. During the procedure, the patient will need to remain still to ensure clear and accurate images.
7. Once the imaging is complete, the images will be interpreted by a radiologist or other qualified healthcare professional.
8. The results of the magnetic resonance angiography without contrast can help in the diagnosis and evaluation of various vascular conditions in the upper extremity.

4. When to use HCPCS code C8935

HCPCS code C8935 should be used when performing magnetic resonance angiography without contrast for the upper extremity. This procedure is typically ordered by healthcare providers when there is a suspicion of vascular abnormalities or conditions affecting the blood vessels in the arm, shoulder, or surrounding area. It is important to ensure that the procedure is medically necessary and meets the specific criteria for using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C8935, healthcare providers need to ensure proper documentation of the procedure. This includes the medical necessity for performing the magnetic resonance angiography without contrast, the specific details of the procedure, and the interpretation of the results. Additionally, any supporting documentation, such as clinical notes or imaging reports, should be included to substantiate the need for the procedure and the accuracy of the billed code.

6. Historical Information and Code Maintenance

HCPCS code C8935 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. This code has been in use for several years and has remained unchanged in terms of its description and usage.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may cover the magnetic resonance angiography without contrast for the upper extremity when it is deemed medically necessary. The pricing indicator code for HCPCS code C8935 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 check with individual payers to determine their specific coverage policies and reimbursement rates for this procedure.

8. Examples

Here are some examples of when HCPCS code C8935 should be billed:

1. A patient presents with symptoms of arm pain and reduced range of motion. The healthcare provider suspects a vascular abnormality in the upper extremity and orders a magnetic resonance angiography without contrast to evaluate the blood vessels.
2. A patient with a history of arterial stenosis in the upper extremity undergoes regular monitoring to assess the progression of the condition. Magnetic resonance angiography without contrast is performed to obtain detailed images of the blood vessels and evaluate any changes.
3. A patient with a suspected vascular malformation in the shoulder area is referred for a magnetic resonance angiography without contrast. The procedure helps in visualizing the blood vessels and determining the presence and extent of the malformation.
4. A patient who has undergone previous upper extremity surgery experiences persistent swelling and pain. Magnetic resonance angiography without contrast is ordered to rule out any vascular complications related to the surgery.
5. A patient with a suspected aneurysm in the upper extremity is scheduled for a magnetic resonance angiography without contrast. The procedure aids in identifying the presence and location of the aneurysm, guiding further treatment decisions.