How To Use HCPCS Code C9122

HCPCS code C9122 describes the Mometasone furoate sinus implant, 10 micrograms (sinuva). This code is used to identify a specific type of sinus implant that contains mometasone furoate, a corticosteroid medication. The implant is designed to be inserted into the sinuses to provide long-lasting relief for patients with chronic sinusitis.

1. What is HCPCS C9122?

HCPCS code C9122 is a specific code used in medical coding to identify the Mometasone furoate sinus implant, 10 micrograms (sinuva). It is important for medical coders to accurately assign this code when billing for the insertion of this sinus implant.

2. Official Description

The official description of HCPCS code C9122 is “Mometasone furoate sinus implant, 10 micrograms (sinuva)”. The short description for this code is “Parenteral supp not othrws c”. These descriptions provide a clear and concise understanding of the specific sinus implant being coded.

3. Procedure

  1. The procedure for inserting the Mometasone furoate sinus implant involves the following steps:
    • The patient is positioned comfortably, usually in a reclined position.
    • The healthcare provider applies a local anesthetic to numb the nasal area.
    • A small incision is made in the nasal passage to access the sinuses.
    • The Mometasone furoate sinus implant is carefully inserted into the sinuses using specialized instruments.
    • The incision is closed, and any excess bleeding is controlled.
    • The patient is monitored for any immediate complications or adverse reactions.

4. When to use HCPCS code C9122

HCPCS code C9122 should be used when billing for the insertion of the Mometasone furoate sinus implant. This code is specifically for the 10 micrograms (sinuva) implant and should only be used when this specific implant is utilized. It is important to review the patient’s medical records and documentation to ensure the correct implant is being coded.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9122, healthcare providers need to document the following information:

  • Medical necessity for the sinus implant insertion
  • Details of the procedure, including the specific implant used
  • Any complications or adverse reactions encountered during the procedure
  • Any additional services or supplies provided during the same encounter

It is important to accurately code and document the procedure to ensure proper reimbursement and compliance with coding guidelines.

6. Historical Information and Code Maintenance

HCPCS code C9122 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 1996. This code was terminated on March 31, 2021. The termination of this code means that it is no longer valid for use in medical coding and billing.

7. Medicare and Insurance Coverage

HCPCS code C9122 may have specific coverage instructions that apply, as indicated by the coverage code D. It is important to review the specific coverage guidelines provided by Medicare or other insurance carriers to determine the reimbursement eligibility for this code. 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 it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9122 should be billed:

  1. A patient with chronic sinusitis undergoes a surgical procedure to have the Mometasone furoate sinus implant inserted.
  2. A healthcare provider performs the insertion of the Mometasone furoate sinus implant as part of a sinus surgery procedure.
  3. A patient with chronic sinusitis receives the Mometasone furoate sinus implant during an office visit for sinusitis management.
  4. A healthcare provider inserts the Mometasone furoate sinus implant as a standalone procedure to provide long-lasting relief for a patient with chronic sinusitis.
  5. A patient with chronic sinusitis undergoes a revision surgery, and the Mometasone furoate sinus implant is inserted during the procedure.

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