How To Use HCPCS Code C9094

HCPCS code C9094 describes the injection of sutimlimab-jome, 10 mg. This code is used to identify the administration of this specific medication, which is used for the treatment of certain medical conditions. In this article, we will explore the details of HCPCS code C9094, 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 C9094?

HCPCS code C9094 is a specific code that is used to identify the injection of sutimlimab-jome, 10 mg. This code is unique to this medication and is used by medical coders to accurately report and bill for the administration of this treatment.

2. Official Description

The official description of HCPCS code C9094 is “Inj, sutimlimab-jome, 10 mg”. The short description for this code is “Parenteral supp not othrws c”. These descriptions provide a concise summary of the code and its purpose.

3. Procedure

1. Prepare the medication: The healthcare provider will gather the necessary supplies and prepare the sutimlimab-jome medication for administration.
2. Verify patient information: The provider will confirm the patient’s identity and ensure that the correct medication and dosage are being administered.
3. Administer the injection: The healthcare provider will administer the sutimlimab-jome injection to the patient. This may involve locating an appropriate injection site and using proper technique to ensure accurate delivery of the medication.
4. Monitor the patient: After the injection, the healthcare provider will monitor the patient for any immediate adverse reactions or side effects.
5. Document the procedure: The healthcare provider will document the administration of sutimlimab-jome, including the dosage, route of administration, and any relevant patient information.

4. When to use HCPCS code C9094

HCPCS code C9094 should be used when administering the medication sutimlimab-jome, 10 mg. It is important to ensure that the medication being administered matches the description provided in the code. This code should only be used for the specific medication and dosage mentioned.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of sutimlimab-jome using HCPCS code C9094, healthcare providers should ensure that they have the necessary documentation to support the claim. This may include the patient’s medical record, documentation of the medication administered, dosage, route of administration, and any other relevant information. It is important to follow the billing guidelines set forth by the payer to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9094 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has a termination date of September 30, 2022. This code has not undergone any maintenance actions, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated on any changes or revisions to HCPCS codes to ensure accurate reporting and billing.

7. Medicare and Insurance Coverage

HCPCS code C9094 is covered by Medicare and other insurance providers. 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 that it is not applicable as HCPCS priced under one methodology. It is important to verify coverage and reimbursement policies with the specific payer to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code C9094 should be billed:

1. A patient with a diagnosed medical condition requiring the administration of sutimlimab-jome, 10 mg.
2. A patient undergoing a specific treatment protocol that includes the administration of sutimlimab-jome, 10 mg.
3. A patient receiving sutimlimab-jome, 10 mg as part of a clinical trial or research study.
4. A patient with a documented allergy or intolerance to other medications, necessitating the use of sutimlimab-jome, 10 mg.
5. A patient with a medical history indicating the need for ongoing treatment with sutimlimab-jome, 10 mg.