How To Use HCPCS Code C9056

HCPCS code C9056 describes the injection of givosiran, 0.5 mg. This code is used to identify the specific procedure of administering givosiran through injection, with a dosage of 0.5 mg. In this article, we will explore the details of HCPCS code C9056, 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 C9056?

HCPCS code C9056 is a specific code used to identify the injection of givosiran, 0.5 mg. It is important for medical coders to correctly assign this code when documenting and billing for the administration of givosiran.

2. Official Description

The official description of HCPCS code C9056 is “Injection, givosiran, 0.5 mg”. The short description for this code is “Parenteral supp not othrws c”. This description accurately represents the procedure of administering givosiran through injection with a dosage of 0.5 mg.

3. Procedure

1. Prepare the necessary equipment and supplies for the injection of givosiran.
2. Verify the patient’s identity and confirm the correct dosage of 0.5 mg.
3. Cleanse the injection site with an appropriate antiseptic solution.
4. Administer the givosiran injection using the appropriate technique and needle size.
5. Monitor the patient for any adverse reactions or complications.
6. Document the procedure in the patient’s medical record.

4. When to use HCPCS code C9056

HCPCS code C9056 should be used when documenting and billing for the injection of givosiran with a dosage of 0.5 mg. This code is specific to this particular procedure and should not be used for any other injections or medications.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of givosiran using HCPCS code C9056, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation of the patient’s identity and medical necessity for the procedure.
• Documentation of the dosage administered (0.5 mg) and any additional relevant information.
• Proper coding and inclusion of HCPCS code C9056 on the claim form.

6. Historical Information and Code Maintenance

HCPCS code C9056 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. This code has a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology. HCPCS code C9056 was terminated on June 30, 2020.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9056 may vary. It is important to check with the specific payer to determine if this code is payable and to understand the pricing and coverage guidelines. The Medicare Carriers Manual Reference Section Number for this code is 2130, which provides additional information on coverage and reimbursement.

8. Examples

Here are five examples of scenarios where HCPCS code C9056 should be billed:

1. A patient with a confirmed diagnosis of a specific condition requires the injection of givosiran as part of their treatment plan.
2. A healthcare provider administers givosiran, 0.5 mg, to a patient with a documented medical necessity for this medication.
3. A patient receives an injection of givosiran, 0.5 mg, during a scheduled outpatient visit.
4. A healthcare provider administers givosiran, 0.5 mg, to a patient in a hospital setting.
5. A patient receives multiple injections of givosiran, 0.5 mg, over a specified period of time as part of their ongoing treatment.