How To Use HCPCS Code C9257

HCPCS code C9257 describes the injection of bevacizumab, a medication used in the treatment of various types of cancer. This code is specifically used to identify the administration of 0.25 mg of bevacizumab via injection. In this article, we will explore the details of HCPCS code C9257, 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 C9257?

HCPCS code C9257 is used to identify the injection of bevacizumab, a medication commonly used in the treatment of cancer. This code specifically represents the administration of 0.25 mg of bevacizumab via injection. It is important for medical coders to accurately assign this code when documenting and billing for the administration of bevacizumab.

2. Official Description

The official description of HCPCS code C9257 is “Injection, bevacizumab, 0.25 mg.” This description clearly states the specific medication and dosage being administered via injection. The short description for this code is “Parenteral supp not othrws c,” which indicates that this code is used for parenteral supplementation that does not fall under any other specific category.

3. Procedure

1. Prepare the necessary equipment and supplies for the injection of bevacizumab.
2. Verify the patient’s identity and confirm the correct medication and dosage.
3. Ensure proper hand hygiene and use appropriate personal protective equipment.
4. Select an appropriate injection site and clean the area with an antiseptic solution.
5. Prepare the bevacizumab medication according to manufacturer instructions.
6. Administer the injection of 0.25 mg of bevacizumab using the appropriate technique.
7. Observe the patient for any immediate adverse reactions or complications.
8. Document the administration of bevacizumab, including the dosage, route, and any relevant patient information.

4. When to use HCPCS code C9257

HCPCS code C9257 should be used when documenting and billing for the injection of bevacizumab at a dosage of 0.25 mg. This code is specifically for parenteral supplementation that does not fall under any other specific category. It is important to ensure that the administration of bevacizumab meets the criteria outlined in the official description of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9257, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s identity and relevant medical history
• Documentation of the administration of bevacizumab, including the dosage and route
• Documentation of any immediate adverse reactions or complications
• Documentation of any additional services or supplies provided in conjunction with the injection

Providers should also follow the billing guidelines set forth by the relevant insurance carriers to ensure accurate and timely reimbursement for the administration of bevacizumab.

6. Historical Information and Code Maintenance

HCPCS code C9257 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition to the system.

7. Medicare and Insurance Coverage

HCPCS code C9257 is covered by Medicare and other insurance carriers. The pricing indicator code 57 indicates that this code is priced by other carriers. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions regarding the coverage and reimbursement of HCPCS code C9257.

8. Examples

Here are five examples of when HCPCS code C9257 should be billed:

1. A patient with advanced lung cancer receives an injection of 0.25 mg of bevacizumab as part of their chemotherapy regimen.
2. A patient with metastatic colorectal cancer receives an injection of 0.25 mg of bevacizumab to help shrink their tumors.
3. A patient with ovarian cancer receives an injection of 0.25 mg of bevacizumab to inhibit the growth of new blood vessels in the tumor.
4. A patient with glioblastoma receives an injection of 0.25 mg of bevacizumab to target the tumor’s blood supply.
5. A patient with renal cell carcinoma receives an injection of 0.25 mg of bevacizumab to slow the progression of the disease.