How To Use HCPCS Code C9473

HCPCS code C9473 describes the injection of mepolizumab, with a dosage of 1 mg. This code is used to identify the administration of this specific medication and is typically used in medical coding and billing processes. In this article, we will explore the details of HCPCS code C9473, 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 C9473?

HCPCS code C9473 is a specific code used to identify the injection of mepolizumab, with a dosage of 1 mg. This code is used in medical coding and billing to accurately document and bill for the administration of this medication. It is important for medical coders to correctly assign this code to ensure accurate reimbursement and claims processing.

2. Official Description

The official description of HCPCS code C9473 is “Injection, mepolizumab, 1 mg.” This description clearly indicates that this code is used to identify the administration of mepolizumab, with a dosage of 1 mg. The short description for this code is “Enteral supp not otherwise c,” which provides additional information about the nature of the service or supply.

3. Procedure

1. The provider prepares the necessary equipment and medication for the injection of mepolizumab.
2. The provider verifies the patient’s identity and confirms the correct dosage of 1 mg.
3. The provider cleans the injection site and prepares the patient for the injection.
4. The provider administers the injection of mepolizumab, ensuring proper technique and safety measures.
5. After the injection, the provider monitors the patient for any immediate adverse reactions or side effects.
6. The provider documents the administration of mepolizumab, including the dosage, route of administration, and any relevant patient information.

4. When to use HCPCS code C9473

HCPCS code C9473 should be used when documenting and billing for the injection of mepolizumab, with a dosage of 1 mg. This code is specific to this medication and dosage, and should not be used for any other medications or dosages. It is important to review the official description and guidelines for this code to ensure accurate usage.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9473, healthcare providers need to document the administration of mepolizumab, including the dosage of 1 mg, route of administration, and any relevant patient information. It is important to follow the specific documentation requirements of the healthcare facility and any applicable coding guidelines to ensure accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9473 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 C9473 may be payable by Medicare and other insurance providers. The specific coverage instructions for this code may apply, as indicated by the coverage code D. It is important to review the Medicare Carriers Manual Reference Section Number 2130 for any additional information or guidelines related to the coverage and reimbursement of this code.

8. Examples

Here are five examples of when HCPCS code C9473 should be billed:

1. A patient with severe asthma receives an injection of mepolizumab, with a dosage of 1 mg, as part of their ongoing treatment plan.
2. A healthcare provider administers mepolizumab, with a dosage of 1 mg, to a patient with eosinophilic granulomatosis with polyangiitis.
3. A patient with chronic obstructive pulmonary disease (COPD) receives an injection of mepolizumab, with a dosage of 1 mg, to help manage their symptoms.
4. A healthcare provider administers mepolizumab, with a dosage of 1 mg, to a patient with severe nasal polyps as part of their treatment plan.
5. A patient with hypereosinophilic syndrome receives an injection of mepolizumab, with a dosage of 1 mg, to help control their eosinophil levels.