How To Use HCPCS Code C9484

HCPCS code C9484 describes the injection of eteplirsen, a medication used in the treatment of certain genetic disorders. This article will provide an overview of HCPCS code C9484, including its official description, procedure, when to use the code, billing guidelines and documentation requirements, historical information and code maintenance, Medicare and insurance coverage, as well as examples of when this code should be billed.

1. What is HCPCS C9484?

HCPCS code C9484 is used to identify the injection of eteplirsen, a medication that is administered parenterally. This code is specifically used for the injection of 10 mg of eteplirsen.

2. Official Description

The official description of HCPCS code C9484 is “Injection, eteplirsen, 10 mg”. The short description for this code is “Parenteral supp not othrws c”.

3. Procedure

1. Prepare the medication: Ensure that the eteplirsen medication is properly stored and prepared according to the manufacturer’s instructions.
2. Verify patient information: Confirm the patient’s identity and ensure that the correct medication and dosage are being administered.
3. Prepare the injection site: Cleanse the injection site with an appropriate antiseptic solution.
4. Administer the injection: Use a sterile syringe and needle to inject the 10 mg of eteplirsen into the patient’s muscle or subcutaneous tissue, following proper injection techniques.
5. Dispose of sharps and waste: Safely dispose of used needles, syringes, and any other waste materials according to applicable regulations and guidelines.

4. When to use HCPCS code C9484

HCPCS code C9484 should be used when administering the injection of eteplirsen to a patient. It is important to ensure that the patient meets the specific eligibility criteria or guidelines for receiving this medication.

5. Billing Guidelines and Documentation Requirements

When billing for the injection of eteplirsen using HCPCS code C9484, healthcare providers should ensure that the following documentation is included:

• Medical record documentation supporting the medical necessity of the injection
• Date of service
• Quantity of eteplirsen administered (10 mg)
• Any applicable modifiers or additional codes, if required

6. Historical Information and Code Maintenance

HCPCS code C9484 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has a termination date of December 31, 2017. No maintenance actions have been 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 insurance coverage for HCPCS code C9484 may vary. 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 it is not applicable as HCPCS priced under one methodology. It is important to check with the specific insurance provider or Medicare for coverage and reimbursement information.

8. Examples

Here are five examples of when HCPCS code C9484 should be billed:

1. A patient with a confirmed diagnosis of a genetic disorder requiring treatment with eteplirsen receives an injection of 10 mg of the medication.
2. A healthcare provider administers the injection of eteplirsen to a patient as part of their ongoing treatment plan.
3. A patient receives an injection of eteplirsen during a hospital stay for the management of their genetic disorder.
4. A physician administers the injection of eteplirsen in their office as an outpatient procedure.
5. A patient receives the injection of eteplirsen as part of a clinical trial or research study.