How To Use HCPCS Code C9460

HCPCS code C9460 describes the injection of cangrelor, 1 mg. This code is used to identify the administration of cangrelor, a medication used to prevent blood clots in patients undergoing certain medical procedures. In this article, we will explore the details of HCPCS code C9460, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C9460?

HCPCS code C9460 is used to identify the injection of cangrelor, 1 mg. Cangrelor is a medication that belongs to the class of antiplatelet drugs. It works by preventing platelets in the blood from sticking together and forming clots. This code is specifically used to report the administration of cangrelor through injection.

2. Official Description

The official description of HCPCS code C9460 is “Injection, cangrelor, 1 mg.” The short description is “Parenteral supply not otherwise classified.”

3. Procedure

1. Prepare the necessary equipment and supplies for the injection of cangrelor.
2. Verify the patient’s identity and confirm the correct dosage of cangrelor.
3. Select an appropriate injection site, ensuring proper aseptic technique.
4. Administer the cangrelor injection using the appropriate needle and syringe.
5. Monitor the patient for any adverse reactions or complications following the injection.

4. When to use HCPCS code C9460

HCPCS code C9460 should be used when reporting the administration of cangrelor, 1 mg, through injection. It is important to use this code only when the injection of cangrelor is performed, and not for any other medications or procedures.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9460, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s medical necessity for receiving cangrelor.
• Documentation of the dosage and administration route of cangrelor.
• Documentation of any complications or adverse reactions related to the injection.

Providers should also follow the appropriate billing guidelines and submit the necessary supporting documentation to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9460 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. The code has a pricing indicator code of 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. The code has an action code of N, meaning no maintenance actions have been taken for this code.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code C9460 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. Other insurance carriers may also have their own coverage policies for this code.

8. Examples

Here are five examples of when HCPCS code C9460 should be billed:

1. A patient undergoes percutaneous coronary intervention (PCI) and receives an injection of cangrelor during the procedure.
2. A patient undergoes coronary artery bypass graft (CABG) surgery and receives an injection of cangrelor before the procedure.
3. A patient with acute coronary syndrome receives an injection of cangrelor as part of their treatment plan.
4. A patient with a history of blood clotting disorders receives an injection of cangrelor prior to a high-risk medical procedure.
5. A patient with a stent in place receives regular injections of cangrelor to prevent clot formation.