How To Use HCPCS Code C9468

HCPCS code C9468 describes the injection of factor IX, also known as antihemophilic factor, recombinant, glycopegylated, under the brand name Rebinyn. This code is used to identify the administration of this specific medication for the treatment of hemophilia B, a genetic bleeding disorder caused by a deficiency of clotting factor IX.

1. What is HCPCS C9468?

HCPCS code C9468 is a specific code used in medical coding to identify the injection of factor IX, a clotting factor used in the treatment of hemophilia B. This code is unique to the medication Rebinyn, which is a glycopegylated form of recombinant factor IX. It is important for medical coders to accurately assign this code when billing for the administration of this medication.

2. Official Description

The official description of HCPCS code C9468 is “Injection, factor IX (antihemophilic factor, recombinant), glycopegylated, Rebinyn, 1 i.u.” The short description for this code is “Parenteral supply, not otherwise classified.” These descriptions provide specific details about the medication being administered and the method of administration.

3. Procedure

1. Prepare the medication: The healthcare provider will prepare the Rebinyn medication according to the manufacturer’s instructions.
2. Verify patient information: The provider will confirm the patient’s identity and ensure that the correct medication and dosage are being administered.
3. Administer the injection: The healthcare provider will administer the injection of Rebinyn, following proper sterile technique and using the appropriate needle and syringe.
4. Monitor the patient: After the injection, the provider will monitor the patient for any adverse reactions or complications.

4. When to use HCPCS code C9468

HCPCS code C9468 should be used when billing for the administration of Rebinyn, the glycopegylated form of recombinant factor IX. This medication is specifically used for the treatment of hemophilia B, a clotting disorder caused by a deficiency of factor IX. It is important to ensure that the patient meets the criteria for receiving this medication and that the administration is documented appropriately.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9468, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s diagnosis of hemophilia B
• Documentation of the administration of Rebinyn, including the date, time, dosage, and route of administration
• Any relevant supporting documentation, such as medical necessity or prior authorization

6. Historical Information and Code Maintenance

HCPCS code C9468 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has a termination date of December 31, 2018, indicating that it is no longer in use. The code has a pricing indicator code of 57, which means it is priced by other carriers. 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

Medicare and other insurance providers may provide coverage for the administration of Rebinyn under HCPCS code C9468. The specific coverage instructions and pricing may vary depending on the individual insurance plan. It is important for healthcare providers to verify coverage and follow the billing guidelines set forth by the insurance carrier.

8. Examples

Here are five examples of scenarios in which HCPCS code C9468 would be used:

1. A patient with hemophilia B receives an injection of Rebinyn during a routine clinic visit.
2. A patient with hemophilia B undergoes a surgical procedure and requires the administration of Rebinyn before and after the surgery.
3. A patient with hemophilia B experiences a bleeding episode and receives an emergency injection of Rebinyn in the emergency department.
4. A patient with hemophilia B receives regular prophylactic injections of Rebinyn to prevent bleeding episodes.
5. A patient with hemophilia B receives an injection of Rebinyn during a home healthcare visit.