How To Use HCPCS Code C9038

HCPCS code C9038 describes the injection of mogamulizumab-kpkc, 1 mg. In this article, we will explore the details of this code, 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 C9038?

HCPCS code C9038 is used to identify the injection of mogamulizumab-kpkc, 1 mg. This code specifically represents the administration of this medication through injection.

2. Official Description

The official description of HCPCS code C9038 is “Injection, mogamulizumab-kpkc, 1 mg.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The healthcare provider prepares the mogamulizumab-kpkc medication for injection.
2. The provider cleans the injection site and prepares the patient for the procedure.
3. The provider administers the injection of mogamulizumab-kpkc, 1 mg, following proper sterile technique.
4. After the injection, the provider disposes of any used materials and ensures the patient’s comfort and safety.

4. When to use HCPCS code C9038

HCPCS code C9038 should be used when a healthcare provider administers the injection of mogamulizumab-kpkc, 1 mg, to a patient. This code is specific to the administration of this medication and should not be used for any other purpose.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9038, healthcare providers should ensure that the documentation includes the following:

• Proof of medical necessity for the administration of mogamulizumab-kpkc, 1 mg.
• Date and time of the injection.
• Quantity of mogamulizumab-kpkc administered.
• Any relevant patient information, such as allergies or adverse reactions.

6. Historical Information and Code Maintenance

HCPCS code C9038 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has a termination date of September 30, 2019. This code has not undergone any maintenance actions, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9038 may vary. 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. Healthcare providers should check with the specific insurance carrier or Medicare for coverage and reimbursement information.

8. Examples

Here are five examples of when HCPCS code C9038 should be billed:

1. A patient with a diagnosis of cutaneous T-cell lymphoma receives an injection of mogamulizumab-kpkc, 1 mg, as part of their treatment plan.
2. A healthcare provider administers mogamulizumab-kpkc, 1 mg, to a patient with relapsed or refractory adult T-cell leukemia-lymphoma.
3. A patient with mycosis fungoides receives an injection of mogamulizumab-kpkc, 1 mg, to manage their symptoms.
4. A healthcare provider administers mogamulizumab-kpkc, 1 mg, to a patient with Sézary syndrome as part of their ongoing therapy.
5. A patient with advanced cutaneous T-cell lymphoma receives an injection of mogamulizumab-kpkc, 1 mg, to slow disease progression.