How To Use HCPCS Code C9146

HCPCS code C9146 describes the injection of mirvetuximab soravtansine-gynx, with a dosage of 1 mg. This code is used to identify the specific procedure of administering this medication to patients. In this article, we will explore the details of HCPCS code C9146, 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 C9146?

HCPCS code C9146 is a specific code used to identify the injection of mirvetuximab soravtansine-gynx, with a dosage of 1 mg. This code is essential for medical coders and billers to accurately document and bill for this particular procedure. It allows healthcare providers to track and report the administration of this medication for reimbursement purposes.

2. Official Description

The official description of HCPCS code C9146 is “Injection, mirvetuximab soravtansine-gynx, 1 mg.” This description precisely defines the procedure being performed, providing clarity and accuracy in medical coding and billing.

3. Procedure

1. Prepare the medication: Before administering the injection, the healthcare provider must ensure that the mirvetuximab soravtansine-gynx medication is properly prepared according to the manufacturer’s instructions.
2. Verify patient information: Confirm the patient’s identity and ensure that the correct dosage of 1 mg is prescribed for the specific patient.
3. Administer the injection: Using a sterile syringe and needle, the healthcare provider will administer the mirvetuximab soravtansine-gynx injection to the patient. The injection site may vary depending on the specific instructions provided by the manufacturer.
4. Monitor the patient: After the injection, the healthcare provider will closely monitor the patient for any adverse reactions or side effects. They will also provide any necessary post-injection instructions to the patient.

4. When to use HCPCS code C9146

HCPCS code C9146 should be used when the healthcare provider administers the mirvetuximab soravtansine-gynx injection to a patient. It is important to ensure that the dosage of 1 mg matches the prescribed amount for the specific patient. This code should only be used for the designated medication and dosage mentioned in the official description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9146, healthcare providers need to ensure proper documentation of the procedure. This includes documenting the patient’s identity, the dosage administered, and any relevant information regarding the administration of the injection. It is crucial to follow the specific billing guidelines provided by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9146 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 termination date of June 30, 2023, indicating that it will no longer be valid for use after this date. The termination of a code may be due to various reasons, such as the introduction of a new code or changes in medical practices.

7. Medicare and Insurance Coverage

HCPCS code C9146 falls under the coverage code D, which means that special coverage instructions apply. This indicates that there may be specific eligibility criteria or guidelines for using this code, which healthcare providers need to be aware of when billing for this procedure. The pricing indicator code for this code is 57, which signifies that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9146 should be billed:

1. A patient with ovarian cancer receives the mirvetuximab soravtansine-gynx injection as part of their chemotherapy regimen.
2. A healthcare provider administers the mirvetuximab soravtansine-gynx injection to a patient participating in a clinical trial for gynecological cancers.
3. A patient with recurrent endometrial cancer receives the mirvetuximab soravtansine-gynx injection as a targeted therapy.
4. A healthcare provider administers the mirvetuximab soravtansine-gynx injection to a patient with advanced cervical cancer.
5. A patient with fallopian tube cancer receives the mirvetuximab soravtansine-gynx injection as part of their treatment plan.