How To Use HCPCS Code C9476

HCPCS code C9476 describes the injection of daratumumab, with a dosage of 10 mg. This code is used to identify the administration of this specific medication in a healthcare setting. In this article, we will explore the details of HCPCS code C9476, 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 C9476?

HCPCS code C9476 is used to identify the injection of daratumumab, a medication with a dosage of 10 mg. This code specifically refers to the administration of daratumumab in a healthcare setting. It is important to use this code accurately to ensure proper documentation and billing for this specific procedure.

2. Official Description

The official description of HCPCS code C9476 is “Injection, daratumumab, 10 mg”. This description clearly indicates that this code is used to identify the injection of daratumumab with a dosage of 10 mg. The short description for this code is “Parenteral supp not othrws c”, which further emphasizes that this code is specific to the administration of daratumumab.

3. Procedure

1. The provider prepares the daratumumab injection according to the manufacturer’s instructions.
2. The provider verifies the patient’s identity and confirms the correct dosage of 10 mg.
3. The provider cleans the injection site with an antiseptic solution.
4. The provider uses a sterile syringe and needle to administer the daratumumab injection.
5. After the injection, the provider disposes of the used syringe and needle in a proper sharps container.
6. The provider documents the administration of daratumumab in the patient’s medical record.

4. When to use HCPCS code C9476

HCPCS code C9476 should be used when a healthcare provider administers daratumumab to a patient. This code is specific to the injection of daratumumab with a dosage of 10 mg. It is important to use this code accurately to ensure proper documentation and billing for this procedure.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of daratumumab using HCPCS code C9476, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s identity
• Documentation of the correct dosage of 10 mg
• Documentation of the administration of daratumumab
• Proper coding of HCPCS code C9476 on the claim form

By meeting these documentation requirements, healthcare providers can accurately bill for the administration of daratumumab using HCPCS code C9476.

6. Historical Information and Code Maintenance

HCPCS code C9476 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. This code was terminated on December 31, 2016. The termination of this code means that it is no longer valid for use in documentation and billing. It is important for healthcare providers to use the most up-to-date and valid codes when documenting and billing for procedures.

7. Medicare and Insurance Coverage

HCPCS code C9476 is subject to Medicare coverage and reimbursement. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means that it is not applicable as HCPCS priced under one methodology. Healthcare providers should consult the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions regarding the coverage and reimbursement of HCPCS code C9476.

8. Examples

Here are five examples of when HCPCS code C9476 should be billed:

1. A patient with multiple myeloma receives an injection of daratumumab with a dosage of 10 mg during a chemotherapy session.
2. A healthcare provider administers daratumumab to a patient with relapsed or refractory multiple myeloma as part of their treatment plan.
3. A patient with newly diagnosed multiple myeloma receives daratumumab as part of their initial treatment regimen.
4. A healthcare provider administers daratumumab to a patient with smoldering multiple myeloma to delay disease progression.
5. A patient with light-chain amyloidosis receives an injection of daratumumab to target abnormal plasma cells.