How To Use HCPCS Code C9470

HCPCS code C9470 describes the injection of aripiprazole lauroxil, 1 mg. This code is used to identify the administration of this specific medication in a parenteral form. In this article, we will explore the details of HCPCS code C9470, 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 C9470?

HCPCS code C9470 is a specific code used to identify the injection of aripiprazole lauroxil, 1 mg. It is important to note that HCPCS codes are used for reporting medical procedures, services, and supplies for reimbursement purposes. This code allows healthcare providers and insurance companies to accurately document and bill for the administration of aripiprazole lauroxil.

2. Official Description

The official description of HCPCS code C9470 is “Injection, aripiprazole lauroxil, 1 mg.” This description clearly states the specific medication and dosage that is being administered through injection.

3. Procedure

1. Prepare the necessary equipment and supplies for the injection.
2. Verify the patient’s identity and confirm the correct medication and dosage.
3. Cleanse the injection site with an appropriate antiseptic solution.
4. Administer the aripiprazole lauroxil injection using the appropriate technique.
5. Monitor the patient for any adverse reactions or complications.
6. Document the administration of the medication, including the dosage, route, and any relevant patient information.

4. When to use HCPCS code C9470

HCPCS code C9470 should be used when a healthcare provider administers an injection of aripiprazole lauroxil, 1 mg. This code is specific to this medication and dosage, and should not be used for any other medications or dosages.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of aripiprazole lauroxil using HCPCS code C9470, healthcare providers should ensure that the following documentation is included:

• Patient’s name and identification number
• Date and time of the injection
• Medication name (aripiprazole lauroxil) and dosage (1 mg)
• Route of administration (injection)
• Any relevant patient information or notes

It is important to accurately document the administration of the medication to ensure proper reimbursement and to maintain a comprehensive medical record for the patient.

6. Historical Information and Code Maintenance

HCPCS code C9470 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 termination date of December 31, 2016, indicating that it is no longer in use after this date. The termination of a code means that it is no longer valid for billing or reimbursement purposes.

7. Medicare and Insurance Coverage

HCPCS code C9470 may have specific coverage instructions that apply, as indicated by the coverage code D. This means that there may be additional guidelines or requirements for Medicare and other insurance providers when using this code. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9470 should be billed:

1. A patient with a diagnosis of schizophrenia receives an injection of aripiprazole lauroxil, 1 mg, as part of their ongoing treatment plan.
2. A healthcare provider administers an injection of aripiprazole lauroxil, 1 mg, to a patient in an outpatient clinic setting.
3. A patient with bipolar disorder receives an injection of aripiprazole lauroxil, 1 mg, to help manage their symptoms.
4. A healthcare provider administers an injection of aripiprazole lauroxil, 1 mg, to a patient who is unable to take the medication orally.
5. A patient with a history of non-compliance with oral medications receives an injection of aripiprazole lauroxil, 1 mg, to ensure medication adherence.