How To Use HCPCS Code C9471

HCPCS code C9471 describes the use of hyaluronan or its derivative, Hymovis, for intra-articular injection. This code is used to identify the specific treatment provided and is important for accurate medical coding and billing.

1. What is HCPCS C9471?

HCPCS code C9471 is a specific code used to identify the use of hyaluronan or its derivative, Hymovis, for intra-articular injection. Intra-articular injections involve the injection of medication directly into a joint, such as the knee, to provide relief from pain and inflammation. Hymovis is a type of hyaluronan, which is a substance naturally found in the body that helps lubricate and cushion joints.

2. Official Description

The official description of HCPCS code C9471 is “Hyaluronan or derivative, Hymovis, for intra-articular injection, 1 mg.” The short description for this code is “Enteral supp not otherwise c.” This description accurately represents the specific treatment being provided and helps healthcare providers and coders identify the correct code for billing purposes.

3. Procedure

1. Prepare the patient for the intra-articular injection, ensuring proper positioning and sterilization of the injection site.
2. Draw up the appropriate dosage of Hymovis, as prescribed by the healthcare provider.
3. Using a sterile syringe and needle, inject the Hymovis into the affected joint, such as the knee.
4. Monitor the patient for any adverse reactions or complications following the injection.

It is important for healthcare providers to follow proper injection techniques and guidelines to ensure the safety and effectiveness of the procedure.

4. When to use HCPCS code C9471

HCPCS code C9471 should be used when a healthcare provider administers hyaluronan or its derivative, Hymovis, via intra-articular injection. This code is specifically for the treatment of joint pain and inflammation and should not be used for other purposes or medications.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9471, healthcare providers should ensure that the documentation supports the medical necessity of the procedure. This may include the patient’s medical history, physical examination findings, and any diagnostic tests that were performed to determine the need for the intra-articular injection. Additionally, providers should include the dosage and administration details in the documentation to support accurate billing.

6. Historical Information and Code Maintenance

HCPCS code C9471 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has a termination date of December 31, 2016. This means that the code is no longer actively used for billing purposes. It is important for healthcare providers to use the most up-to-date codes and follow any coding changes or updates provided by the Centers for Medicare and Medicaid Services (CMS).

7. Medicare and Insurance Coverage

HCPCS code C9471 may have specific coverage instructions that apply, as indicated by the coverage code D. This means that there may be certain criteria or guidelines that need to be met for Medicare or other insurance providers to cover the cost of the treatment. Healthcare providers should verify coverage and reimbursement policies with the respective payers to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code C9471 may be used:

1. A patient with osteoarthritis of the knee receives an intra-articular injection of Hymovis for pain relief.
2. A patient with rheumatoid arthritis undergoes an intra-articular injection of Hymovis to reduce joint inflammation.
3. A patient with a meniscal tear in the knee receives an intra-articular injection of Hymovis as part of their treatment plan.
4. A patient with joint pain and limited mobility due to osteoarthritis in the hip receives an intra-articular injection of Hymovis for symptom management.
5. A patient with a history of joint inflammation and swelling receives regular intra-articular injections of Hymovis to manage their condition.