How To Use HCPCS Code C9039

HCPCS code C9039 describes the injection of plazomicin, a medication used in the treatment of certain bacterial infections. This code is used to identify and bill for the administration of plazomicin in a healthcare setting. In this article, we will explore the details of HCPCS code C9039, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C9039?

HCPCS code C9039 is used to identify the injection of plazomicin, a medication that is prescribed for the treatment of specific bacterial infections. This code is specific to the administration of plazomicin and should be used when billing for this service.

2. Official Description

The official description of HCPCS code C9039 is “Injection, plazomicin, 5 mg.” This description accurately represents the medication and dosage being administered.

3. Procedure

1. The healthcare provider prepares the plazomicin injection according to the manufacturer’s instructions.
2. The provider verifies the patient’s identity and confirms the appropriateness of the medication for the specific bacterial infection being treated.
3. The provider selects an appropriate injection site and cleanses the area with an antiseptic solution.
4. The provider uses a sterile syringe and needle to administer the plazomicin injection into the patient’s muscle or vein, following proper injection techniques.
5. After the injection, the provider disposes of the used syringe and needle in a sharps container.
6. The provider documents the administration of plazomicin in the patient’s medical record, including the date, time, dosage, and any relevant observations or adverse reactions.

4. When to use HCPCS code C9039

HCPCS code C9039 should be used when the healthcare provider administers plazomicin to a patient for the treatment of a bacterial infection. It is important to ensure that the medication and dosage align with the specific code description to accurately bill for the service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9039, healthcare providers should ensure that the following documentation is included:

• Medical record documentation supporting the medical necessity of the plazomicin injection
• Date and time of the administration
• Dosage administered
• Any relevant observations or adverse reactions

Providers should follow the billing guidelines set forth by the payer, ensuring that all necessary information is included on the claim form for accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9039 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 1996. This code has a termination date of September 30, 2019, indicating that it is no longer actively used for billing purposes.

7. Medicare and Insurance Coverage

HCPCS code C9039 falls under Medicare coverage and is eligible for reimbursement. 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, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9039 should be billed:

1. A patient with a diagnosed bacterial infection receives a plazomicin injection in a hospital setting.
2. A physician administers a plazomicin injection to a patient in an outpatient clinic for the treatment of a bacterial infection.
3. A home healthcare nurse administers a plazomicin injection to a patient in their home as part of their ongoing treatment plan.
4. A skilled nursing facility provides plazomicin injections to residents who have been diagnosed with specific bacterial infections.
5. A specialty pharmacy prepares and delivers plazomicin injections to healthcare providers for administration to their patients.