How To Use HCPCS Code C8957
HCPCS code C8957 describes the intravenous infusion for therapy/diagnosis that requires the initiation of a prolonged infusion lasting more than 8 hours, and necessitates the use of a portable or implantable pump. This code falls under the category of enteral supplies not otherwise classified. In this article, we will delve into the details of HCPCS code C8957, 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 C8957?
HCPCS code C8957 is used to identify the initiation of a prolonged intravenous infusion for therapy or diagnosis that requires the use of a portable or implantable pump. This code is specifically for infusions lasting more than 8 hours. It falls under the category of enteral supplies not otherwise classified.
2. Official Description
The official description of HCPCS code C8957 is “Intravenous infusion for therapy/diagnosis; initiation of prolonged infusion (more than 8 hours), requiring use of portable or implantable pump.” The short description for this code is “Enteral supp not otherwise c.”
3. Procedure
- The healthcare provider will initiate the intravenous infusion for therapy or diagnosis.
- The infusion will be prolonged, lasting more than 8 hours.
- A portable or implantable pump will be used to administer the infusion.
4. When to use HCPCS code C8957
HCPCS code C8957 should be used when a healthcare provider initiates a prolonged intravenous infusion for therapy or diagnosis that requires the use of a portable or implantable pump. It is important to note that this code is specifically for infusions lasting more than 8 hours.
5. Billing Guidelines and Documentation Requirements
When billing for HCPCS code C8957, healthcare providers need to document the initiation of the prolonged infusion, the duration of the infusion, and the use of a portable or implantable pump. It is crucial to provide accurate and detailed documentation to support the medical necessity of the service.
6. Historical Information and Code Maintenance
HCPCS code C8957 was added to the Healthcare Common Procedure Coding System on January 01, 1985. 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 related to this code.
7. Medicare and Insurance Coverage
HCPCS code C8957 is covered by Medicare. 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 is priced under one methodology. It is essential to verify coverage and reimbursement policies with individual insurance carriers.
8. Examples
Here are five examples of scenarios where HCPCS code C8957 should be billed:
- A patient requires a prolonged intravenous infusion for chemotherapy that lasts for 10 hours, and a portable pump is used for administration.
- An individual with a chronic condition needs a prolonged intravenous infusion for medication administration that lasts for 12 hours, and an implantable pump is utilized.
- A patient undergoes a diagnostic procedure that requires a prolonged intravenous infusion lasting for 9 hours, and a portable pump is employed.
- An individual receives a therapeutic infusion that lasts for 11 hours, and an implantable pump is utilized for administration.
- A patient requires a prolonged intravenous infusion for hydration that lasts for 14 hours, and a portable pump is used for administration.
