How To Use HCPCS Code C9451

HCPCS code C9451 describes the injection of peramivir, 1 mg. This code is used to identify the administration of peramivir, a medication used for the treatment of influenza. In this article, we will explore the details of HCPCS code C9451, 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 C9451?

HCPCS code C9451 is used to identify the injection of peramivir, 1 mg. Peramivir is an antiviral medication that is administered to patients for the treatment of influenza. This code specifically represents the administration of peramivir through injection.

2. Official Description

The official description of HCPCS code C9451 is “Injection, peramivir, 1 mg.” This description accurately reflects the purpose of this code, which is to identify the administration of peramivir through injection. The short description for this code is “Enteral supp not otherwise c,” indicating that this code is used for enteral supplementation that does not fall under any other specific code.

3. Procedure

1. The provider prepares the peramivir medication for injection.
2. The provider verifies the patient’s identity and confirms the need for peramivir administration.
3. The provider selects an appropriate injection site and cleanses the area with an antiseptic solution.
4. The provider uses a sterile syringe and needle to draw up the prescribed dose of peramivir.
5. The provider administers the peramivir injection into the patient’s muscle or vein, following proper injection techniques.
6. The provider disposes of the used syringe and needle in a sharps container.
7. The provider documents the administration of peramivir, including the date, time, dosage, and any relevant patient information.

4. When to use HCPCS code C9451

HCPCS code C9451 should be used when a healthcare provider administers peramivir to a patient through injection. This code is specifically for the injection of peramivir, 1 mg, and should not be used for other forms of administration or different dosages of peramivir. It is important to ensure that the administration of peramivir meets the criteria specified in the official description of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9451, healthcare providers should ensure that the following documentation is included:

• Date of service
• Time of service
• Dosage of peramivir administered
• Route of administration (injection)
• Any relevant patient information

Providers should follow the specific billing guidelines provided by their respective payers to ensure accurate and timely reimbursement for the administration of peramivir.

6. Historical Information and Code Maintenance

HCPCS code C9451 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. HCPCS code C9451 was terminated on December 31, 2015, and is no longer in use.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code C9451 may vary depending on the specific circumstances and guidelines set by Medicare. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for more information on coverage and reimbursement for this code. Other insurance carriers may also have their own coverage policies and pricing methodologies for HCPCS code C9451.

8. Examples

Here are five examples of when HCPCS code C9451 should be billed:

1. A patient with confirmed influenza receives a 1 mg injection of peramivir at a healthcare facility.
2. A physician administers a 1 mg injection of peramivir to a patient with severe influenza symptoms in an outpatient setting.
3. A hospital nurse administers a 1 mg injection of peramivir to a hospitalized patient with influenza.
4. An emergency room physician administers a 1 mg injection of peramivir to a patient presenting with influenza-like symptoms.
5. A home healthcare nurse administers a 1 mg injection of peramivir to a bedridden patient with influenza at their residence.