How To Use HCPCS Code C9452

HCPCS code C9452 describes the injection of ceftolozane 50 mg and tazobactam 25 mg. This code is used to identify the administration of this specific medication combination. In this article, we will explore the details of HCPCS code C9452, 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 C9452?

HCPCS code C9452 is a specific code used to identify the injection of ceftolozane 50 mg and tazobactam 25 mg. It is important to use this code accurately to ensure proper documentation and billing for this particular medication combination.

2. Official Description

The official description of HCPCS code C9452 is “Injection, ceftolozane 50 mg and tazobactam 25 mg.” This description clearly indicates the specific medication and dosage being administered.

3. Procedure

1. Prepare the medication: Ensure that the correct dosage of ceftolozane (50 mg) and tazobactam (25 mg) is available.
2. Verify patient information: Confirm the patient’s identity and ensure that the medication is intended for the correct individual.
3. Administer the injection: Follow proper injection techniques to administer the ceftolozane and tazobactam combination to the patient.
4. Monitor the patient: Observe the patient for any immediate adverse reactions or side effects following the injection.
5. Document the procedure: Accurately record the administration of ceftolozane 50 mg and tazobactam 25 mg in the patient’s medical records.

4. When to use HCPCS code C9452

HCPCS code C9452 should be used when administering the specific medication combination of ceftolozane 50 mg and tazobactam 25 mg. It is important to ensure that the patient meets the eligibility criteria for receiving this medication and that the administration is performed according to the appropriate guidelines.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of ceftolozane 50 mg and tazobactam 25 mg using HCPCS code C9452, healthcare providers need to document the following:

• Patient information: Include the patient’s name, date of birth, and any relevant medical history.
• Procedure details: Document the specific dosage administered, the date and time of administration, and any relevant notes or observations.
• Provider information: Include the name and credentials of the healthcare provider who performed the administration.

Ensure that the documentation is accurate, complete, and supports the medical necessity of the procedure.

6. Historical Information and Code Maintenance

HCPCS code C9452 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. This code was terminated on December 31, 2015, indicating that it is no longer in use.

7. Medicare and Insurance Coverage

HCPCS code C9452 may have special 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 HCPCS code C9452 is 57, which indicates 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.

It is essential to verify the coverage and reimbursement policies of Medicare and other insurance providers to ensure proper billing and reimbursement for the administration of ceftolozane 50 mg and tazobactam 25 mg.

8. Examples

Here are five examples of when HCPCS code C9452 should be billed:

1. A patient with a severe bacterial infection receives an injection of ceftolozane 50 mg and tazobactam 25 mg as part of their treatment plan.
2. A healthcare provider administers ceftolozane 50 mg and tazobactam 25 mg to a patient with a confirmed diagnosis of a specific bacterial strain that is susceptible to this medication combination.
3. A patient with a compromised immune system requires regular injections of ceftolozane 50 mg and tazobactam 25 mg to prevent infections.
4. A patient undergoes a surgical procedure and receives an injection of ceftolozane 50 mg and tazobactam 25 mg as prophylactic antibiotic therapy.
5. A patient with a documented allergy to other antibiotics is prescribed ceftolozane 50 mg and tazobactam 25 mg as an alternative treatment option.