How To Use HCPCS Code C9092

HCPCS code C9092 describes the injection of triamcinolone acetonide into the suprachoroidal space. This code is used to report the administration of this medication for therapeutic purposes. In this article, we will explore the details of HCPCS code C9092, 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 C9092?

HCPCS code C9092 is a specific code used to identify the injection of triamcinolone acetonide into the suprachoroidal space. This procedure involves delivering the medication directly into the space between the choroid and the sclera of the eye. Triamcinolone acetonide is a corticosteroid that has anti-inflammatory properties and is commonly used in the treatment of various eye conditions.

2. Official Description

The official description of HCPCS code C9092 is “Injection, triamcinolone acetonide, suprachoroidal (xipere), 1 mg.” This description accurately represents the specific procedure and medication involved in this code. The short description for this code is “Parenteral supp not othrws c,” which indicates that this is a parenteral administration of a supplement that does not fall under any other category.

3. Procedure

1. The provider begins by preparing the patient for the procedure, ensuring that the eye is clean and sterile.
2. A local anesthetic may be administered to numb the eye and minimize discomfort.
3. The provider then uses a specialized needle or cannula to access the suprachoroidal space.
4. Triamcinolone acetonide is injected into the suprachoroidal space, delivering the medication directly to the affected area.
5. After the injection, the provider may apply pressure or use other techniques to ensure proper distribution of the medication.
6. The patient is monitored for any immediate adverse reactions or complications.

4. When to use HCPCS code C9092

HCPCS code C9092 should be used when the provider administers an injection of triamcinolone acetonide into the suprachoroidal space. This procedure is typically performed to treat specific eye conditions, such as macular edema or uveitis, where the targeted delivery of the medication to the suprachoroidal space is beneficial. It is important to review the specific coverage instructions and guidelines for this code to ensure proper usage.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9092, healthcare providers need to document the details of the procedure, including the specific eye condition being treated, the dosage of triamcinolone acetonide administered, and any relevant medical history or indications for the treatment. It is essential to follow the documentation requirements of the payer, such as Medicare or other insurance carriers, to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9092 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has been in use for several years to report the administration of triamcinolone acetonide into the suprachoroidal space. As of June 30, 2022, this code has been terminated, meaning it is no longer valid for billing purposes. It is important for medical coders and billers to stay updated on code changes and terminations to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code C9092 may have specific coverage instructions that apply, as indicated by the coverage code D. It is essential to review the guidelines provided by Medicare or other insurance carriers to determine the coverage and reimbursement for this procedure. The pricing indicator code 57 suggests that this code is priced by other carriers, and the multiple pricing indicator code A indicates that it is not applicable as HCPCS priced under one methodology. Providers should consult the Medicare Carriers Manual Reference Section Number 2130 for further guidance on coverage and reimbursement.

8. Examples

Here are five examples of when HCPCS code C9092 should be billed:

1. A patient with diabetic macular edema receives an injection of triamcinolone acetonide into the suprachoroidal space to reduce inflammation and improve visual outcomes.
2. An individual with non-infectious uveitis undergoes the administration of triamcinolone acetonide into the suprachoroidal space to manage the inflammation and alleviate symptoms.
3. A patient with choroidal neovascularization secondary to age-related macular degeneration receives a suprachoroidal injection of triamcinolone acetonide as part of their treatment plan.
4. An individual with posterior uveitis undergoes a suprachoroidal injection of triamcinolone acetonide to control the inflammation and preserve vision.
5. A patient with refractory macular edema following retinal vein occlusion receives a suprachoroidal injection of triamcinolone acetonide to improve macular thickness and visual acuity.