How To Use HCPCS Code C9462

HCPCS code C9462 describes the injection of delafloxacin, 1 mg. This code is used to identify the administration of this specific medication through a parenteral route. In this article, we will explore the details of HCPCS code C9462, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C9462?

HCPCS code C9462 is used to identify the injection of delafloxacin, 1 mg. Delafloxacin is a medication that belongs to the fluoroquinolone antibiotic class and is used to treat certain bacterial infections. This code specifically represents the administration of delafloxacin through a parenteral route, which includes intravenous, intramuscular, or subcutaneous injection.

2. Official Description

The official description of HCPCS code C9462 is “Injection, delafloxacin, 1 mg.” This description accurately reflects the purpose of this code, which is to identify the administration of delafloxacin through injection. The short description for this code is “Parenteral supp not othrws c,” indicating that it is used for parenteral supplementation that does not fall under any other specific category.

3. Procedure

1. Prepare the delafloxacin injection according to the manufacturer’s instructions.
2. Select an appropriate injection site, such as a vein, muscle, or subcutaneous tissue.
3. Cleanse the injection site with an antiseptic solution.
4. If necessary, apply a tourniquet to the patient’s arm to facilitate vein visualization.
5. Insert the needle into the selected site at the appropriate angle and depth.
6. Aspirate to ensure proper needle placement and absence of blood return.
7. If no blood return is observed, slowly inject the delafloxacin solution.
8. Withdraw the needle smoothly and apply pressure to the injection site if necessary.
9. Dispose of the used needle and syringe in a sharps container.
10. Document the administration of delafloxacin, including the date, time, dosage, route, and any adverse reactions or complications.

4. When to use HCPCS code C9462

HCPCS code C9462 should be used when administering delafloxacin through injection for parenteral supplementation. It is important to ensure that the patient meets the specific criteria for receiving this medication and that it is medically necessary for their condition. The use of this code should be supported by appropriate documentation and medical records.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9462, healthcare providers should ensure that the following information is documented and included in the claim:

• Date of service: The date when the delafloxacin injection was administered.
• Dosage: The amount of delafloxacin administered, which should be 1 mg in this case.
• Route of administration: Specify whether the injection was given intravenously, intramuscularly, or subcutaneously.
• Provider information: Include the name, NPI, and credentials of the healthcare provider who administered the injection.
• Medical necessity: Provide supporting documentation that justifies the need for the delafloxacin injection.

6. Historical Information and Code Maintenance

HCPCS code C9462 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an action effective date of January 01, 1996, indicating that no maintenance actions have been taken for this code. The code is priced under other carrier pricing, as indicated by the pricing indicator code 57. The multiple pricing indicator code A signifies that the code is not applicable for multiple pricing methodologies. The Medicare Carriers Manual Reference Section Number for this code is 2130, providing additional guidance for Medicare claims processing.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code C9462 may vary depending on the specific circumstances and guidelines set by the Centers for Medicare and Medicaid Services (CMS). It is important to consult the Medicare Carriers Manual and any applicable Local Coverage Determinations (LCDs) for detailed information on coverage criteria and reimbursement rates. Other insurance carriers may also have their own coverage policies and reimbursement guidelines for this code.

8. Examples

Here are five examples of when HCPCS code C9462 should be billed:

1. A patient with a severe bacterial infection receives a 1 mg intravenous injection of delafloxacin in the hospital.
2. A healthcare provider administers a 1 mg intramuscular injection of delafloxacin to a patient with a skin infection in an outpatient clinic.
3. A home healthcare nurse administers a 1 mg subcutaneous injection of delafloxacin to a patient with a respiratory infection in their home.
4. An emergency room physician administers a 1 mg intravenous injection of delafloxacin to a patient with a life-threatening infection.
5. A patient with a compromised immune system receives a 1 mg intramuscular injection of delafloxacin as part of their ongoing treatment plan.