How To Use HCPCS Code C9467

HCPCS code C9467 describes the injection of rituximab and hyaluronidase, with a dosage of 10 mg. This code is used to identify and bill for this specific procedure in medical coding and billing. In this article, we will explore the details of HCPCS code C9467, 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 C9467?

HCPCS code C9467 is used to identify the injection of rituximab and hyaluronidase, with a dosage of 10 mg. It is important to note that this code is specific to this particular procedure and should not be used for any other injections or treatments.

2. Official Description

The official description of HCPCS code C9467 is “Injection, rituximab and hyaluronidase, 10 mg.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins by preparing the rituximab and hyaluronidase solution according to the manufacturer’s instructions.
2. The provider then cleans the injection site with an antiseptic solution.
3. Using a sterile syringe and needle, the provider administers the rituximab and hyaluronidase solution into the patient’s body.
4. After the injection, the provider disposes of the used syringe and needle in a proper sharps container.
5. The provider may apply a bandage or dressing to the injection site, if necessary.

4. When to use HCPCS code C9467

HCPCS code C9467 should be used when the provider performs the specific procedure of injecting rituximab and hyaluronidase, with a dosage of 10 mg. It is important to ensure that the patient meets the eligibility criteria for this procedure and that it is medically necessary.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9467, healthcare providers need to document the following information:

• Date of service
• Patient’s medical record number
• Description of the procedure performed
• Dosage of rituximab and hyaluronidase administered
• Any additional supplies or medications used during the procedure

Providers should also ensure that they follow the appropriate coding and billing guidelines set forth by their respective payers.

6. Historical Information and Code Maintenance

HCPCS code C9467 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, which means it is not applicable as HCPCS priced under one methodology. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

HCPCS code C9467 may be covered by Medicare and other insurance providers. However, it is important to check with the specific payer to determine their coverage policies and requirements. The Medicare Carriers Manual Reference Section Number for this code is 2130.

8. Examples

Here are five examples of when HCPCS code C9467 should be billed:

1. A patient with a diagnosed autoimmune disorder receives a rituximab and hyaluronidase injection as part of their treatment plan.
2. A patient with a severe joint inflammation receives a rituximab and hyaluronidase injection to alleviate their symptoms.
3. A patient undergoing a specific medical procedure requires a rituximab and hyaluronidase injection to prevent potential complications.
4. A patient with a certain type of cancer receives a rituximab and hyaluronidase injection as part of their chemotherapy regimen.
5. A patient with a chronic inflammatory condition receives regular rituximab and hyaluronidase injections to manage their symptoms.