How To Use HCPCS Code C8936

HCPCS code C8936 describes a specific medical procedure known as magnetic resonance angiography (MRA) of the upper extremity. This procedure involves the use of magnetic resonance imaging (MRI) technology to visualize the blood vessels in the upper extremities without contrast, followed by imaging with contrast. In this article, we will delve into the details of HCPCS code C8936, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C8936?

HCPCS code C8936 is a specific code used to identify the procedure of magnetic resonance angiography without contrast followed by with contrast of the upper extremity. It is important to note that this code is specific to this particular procedure and should not be used for any other purpose.

2. Official Description

The official description of HCPCS code C8936 is “Magnetic resonance angiography without contrast followed by with contrast, upper extremity.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins by positioning the patient on the MRI table, ensuring that the upper extremity to be examined is properly positioned within the MRI machine.
2. The MRI technician then initiates the scan, capturing detailed images of the blood vessels in the upper extremity without the use of contrast.
3. Following the initial scan, the technician administers a contrast agent to the patient, either orally or intravenously, depending on the specific requirements of the procedure.
4. After a sufficient amount of time has passed for the contrast agent to circulate through the bloodstream, the technician performs a second scan to capture images of the blood vessels with the contrast agent present.
5. The resulting images are then analyzed by a radiologist or other qualified healthcare professional to evaluate the condition of the blood vessels in the upper extremity.

4. When to use HCPCS code C8936

HCPCS code C8936 should be used when performing magnetic resonance angiography without contrast followed by with contrast of the upper extremity. This procedure is typically ordered by a healthcare provider to assess the blood flow and detect any abnormalities or blockages in the blood vessels of the upper extremity. It is important to ensure that the specific criteria for using this code are met before submitting it for billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C8936, healthcare providers must 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 any relevant diagnostic test results. Additionally, it is 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 C8936 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 stay updated with any changes or revisions to the code, as well as any updates to the Medicare Carriers Manual reference section number.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C8936 may vary depending on the specific carrier and policy. It is important to consult the Medicare Carriers Manual and the individual insurance carrier’s guidelines to determine coverage and reimbursement rates. 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, which means it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are some examples of when HCPCS code C8936 should be billed:

1. A patient presents with symptoms of peripheral artery disease in the upper extremity. The physician orders a magnetic resonance angiography without contrast followed by with contrast to evaluate the blood vessels and determine the extent of the disease.
2. A patient with a history of trauma to the upper extremity requires an assessment of the blood vessels to rule out any vascular injuries. The physician orders a magnetic resonance angiography without contrast followed by with contrast to obtain detailed images of the blood vessels.
3. A patient with a suspected blood clot in the upper extremity undergoes a magnetic resonance angiography without contrast followed by with contrast to visualize the blood vessels and confirm the presence of a clot.
4. A patient with a known vascular malformation in the upper extremity requires periodic monitoring of the blood vessels. The physician orders a magnetic resonance angiography without contrast followed by with contrast to assess the progression of the malformation.
5. A patient with unexplained pain and swelling in the upper extremity undergoes a magnetic resonance angiography without contrast followed by with contrast to identify any vascular abnormalities that may be causing the symptoms.