How To Use HCPCS Code C9149

HCPCS code C9149 describes an injection of teplizumab-mzwv, with a strength of 5 mcg. This code is used to identify the administration of this specific medication and is typically used in the context of medical coding and billing.

1. What is HCPCS C9149?

HCPCS code C9149 is a specific code used in medical coding to identify the injection of teplizumab-mzwv. It is important to note that HCPCS codes are used to classify and report medical procedures, services, and supplies for reimbursement purposes. This code is specific to the injection of teplizumab-mzwv and should be used when reporting this particular procedure.

2. Official Description

The official description of HCPCS code C9149 is “Injection, teplizumab-mzwv, 5 mcg.” This description accurately represents the procedure being coded and should be used when reporting this code.

3. Procedure

1. Prepare the teplizumab-mzwv injection according to the manufacturer’s instructions.
2. Verify the patient’s identity and confirm the correct dosage of teplizumab-mzwv.
3. Select an appropriate injection site and clean the area with an antiseptic solution.
4. Administer the teplizumab-mzwv injection using the appropriate technique (e.g., subcutaneous, intramuscular).
5. Observe the patient for any immediate adverse reactions or side effects.
6. Document the administration of teplizumab-mzwv in the patient’s medical record.

4. When to use HCPCS code C9149

HCPCS code C9149 should be used when reporting the injection of teplizumab-mzwv. This code is specific to this particular medication and should only be used when this medication is administered. It is important to follow the guidelines and eligibility criteria set forth by the payer when using this code.

5. Billing Guidelines and Documentation Requirements

When billing for the injection of teplizumab-mzwv using HCPCS code C9149, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s identity
• Documentation of the correct dosage of teplizumab-mzwv
• Documentation of the injection site and technique used
• Documentation of any immediate adverse reactions or side effects

Additionally, healthcare providers should follow the billing guidelines set forth by the payer to ensure accurate and timely reimbursement for the service provided.

6. Historical Information and Code Maintenance

HCPCS code C9149 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 pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, indicating that it is not applicable as HCPCS priced under one methodology. It is important to note that HCPCS code C9149 is terminated as of June 30, 2023.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code C9149 may vary depending on the specific circumstances and guidelines set forth by Medicare. It is important to consult the Medicare Carriers Manual Reference Section Number 2130 for specific information regarding coverage and reimbursement for this code. Other insurance providers may also have their own coverage policies and reimbursement guidelines for this code.

8. Examples

Here are five examples of when HCPCS code C9149 should be billed:

1. A patient receives an injection of teplizumab-mzwv for the treatment of a specific medical condition.
2. A healthcare provider administers teplizumab-mzwv to a patient as part of a clinical trial.
3. A patient receives an injection of teplizumab-mzwv as a preventive measure for a high-risk medical condition.
4. A healthcare provider administers teplizumab-mzwv to a patient with a documented allergy to other medications.
5. A patient receives an injection of teplizumab-mzwv as part of a combination therapy for a complex medical condition.