How To Use HCPCS Code C9071

HCPCS code C9071 describes the injection of viltolarsen, 10 mg. This code is used to identify the administration of viltolarsen, a medication used in the treatment of Duchenne muscular dystrophy (DMD). In this article, we will explore the details of HCPCS code C9071, 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 C9071?

HCPCS code C9071 is a specific code used to identify the injection of viltolarsen, 10 mg. It is important for medical coders to accurately assign this code when reporting the administration of viltolarsen to ensure proper reimbursement and documentation.

2. Official Description

The official description of HCPCS code C9071 is “Injection, viltolarsen, 10 mg”. The short description for this code is “Enteral supp not otherwise c”. This description accurately represents the specific medication and dosage being administered.

3. Procedure

1. The provider prepares the viltolarsen injection according to the manufacturer’s instructions.
2. The provider verifies the patient’s identity and confirms the correct dosage of viltolarsen.
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 viltolarsen injection into the patient’s muscle.
5. After the injection, the provider disposes of the used syringe and needle in a sharps container.
6. The provider documents the administration of viltolarsen, including the dosage, injection site, and any relevant patient information.

4. When to use HCPCS code C9071

HCPCS code C9071 should be used when reporting the administration of viltolarsen, 10 mg. It is important to ensure that the patient received the specific medication and dosage described in the code. This code should only be used for the injection of viltolarsen and not for any other medications or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9071, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s identity and relevant medical history
• Documentation of the viltolarsen dosage administered
• Documentation of the injection site
• Documentation of any adverse reactions or complications

Providers should also follow the appropriate billing guidelines and submit the necessary supporting documentation to ensure proper reimbursement for the administration of viltolarsen.

6. Historical Information and Code Maintenance

HCPCS code C9071 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. This code was terminated on March 31, 2021. The termination of this code means that it is no longer valid for use in reporting the administration of viltolarsen.

7. Medicare and Insurance Coverage

HCPCS code C9071 is classified under the HCPCS Coverage Code D, which indicates that special coverage instructions apply. This means that there may be specific eligibility criteria or guidelines for Medicare and other insurance coverage for the administration of viltolarsen.

The pricing indicator code for HCPCS code C9071 is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means that it is not applicable as HCPCS priced under one methodology.

Providers should consult the Medicare Carriers Manual Reference Section Number 2130 for additional information on Medicare coverage and reimbursement for HCPCS code C9071.

8. Examples

Here are five examples of when HCPCS code C9071 should be billed:

1. A 12-year-old male patient with Duchenne muscular dystrophy receives an injection of viltolarsen, 10 mg, at a clinic visit.
2. A 16-year-old female patient with Duchenne muscular dystrophy receives an injection of viltolarsen, 10 mg, during a hospital stay.
3. A 9-year-old male patient with Duchenne muscular dystrophy receives an injection of viltolarsen, 10 mg, at a specialty pharmacy.
4. A 14-year-old female patient with Duchenne muscular dystrophy receives an injection of viltolarsen, 10 mg, at a home healthcare visit.
5. A 10-year-old male patient with Duchenne muscular dystrophy receives an injection of viltolarsen, 10 mg, at a pediatric rehabilitation center.