How To Use HCPCS Code C9487

HCPCS code C9487 describes the medication ustekinumab, which is administered through intravenous injection at a dosage of 1 mg. This code was terminated on June 30, 2017, and falls under the category of enteral supplements not otherwise classified. In this article, we will explore the details of HCPCS code C9487, 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 C9487?

HCPCS code C9487 is used to identify the medication ustekinumab, which is administered through intravenous injection at a dosage of 1 mg. This code is specific to this particular medication and dosage, allowing healthcare providers to accurately document and bill for the service.

2. Official Description

The official description of HCPCS code C9487 is “Ustekinumab, for intravenous injection, 1 mg.” This description clearly indicates the medication, route of administration, and dosage.

3. Procedure

1. Prepare the ustekinumab medication for intravenous injection according to the manufacturer’s instructions.
2. Verify the patient’s identity and confirm the correct dosage of 1 mg.
3. Select an appropriate intravenous access site and prepare the area.
4. Administer the ustekinumab medication slowly and directly into the patient’s vein.
5. Monitor the patient for any adverse reactions or complications during and after the injection.
6. Document the administration of ustekinumab, including the dosage, route of administration, and any relevant patient information.

4. When to use HCPCS code C9487

HCPCS code C9487 should be used when administering ustekinumab through intravenous injection at a dosage of 1 mg. It is important to ensure that the medication, route of administration, and dosage match the official description of the code. This code should only be used for the specific circumstances outlined in the official description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9487, healthcare providers should ensure that the documentation includes the following information:

• Date of service
• Patient’s name and identification number
• Ustekinumab medication details, including dosage and route of administration
• Any relevant patient information or medical history
• Provider’s name and identification number

It is important to follow the specific billing guidelines and requirements of the payer, such as Medicare or private insurance companies, to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9487 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. The code was terminated on June 30, 2017, indicating that it is no longer in use. The termination of the code may be due to changes in medical practices, advancements in treatment options, or other factors.

7. Medicare and Insurance Coverage

HCPCS code C9487 falls under the coverage code D, which indicates that special coverage instructions apply. The pricing indicator code for this code is 57, which means it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are some examples of when HCPCS code C9487 should be billed:

1. A patient with a diagnosed autoimmune condition requires ustekinumab treatment through intravenous injection at a dosage of 1 mg.
2. A healthcare provider administers ustekinumab intravenously to a patient as part of a clinical trial.
3. A patient with severe psoriasis receives ustekinumab intravenously at a dosage of 1 mg to manage their symptoms.
4. An individual with Crohn’s disease undergoes ustekinumab therapy through intravenous injection at a dosage of 1 mg.
5. A healthcare provider administers ustekinumab intravenously to a patient with psoriatic arthritis to alleviate their symptoms.