How To Use HCPCS Code C9490

HCPCS code C9490 describes the injection of bezlotoxumab, with a dosage of 10 mg. This code is used to identify the specific procedure of administering bezlotoxumab through injection. In this article, we will explore the details of HCPCS code C9490, 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 C9490?

HCPCS code C9490 is a specific code used to identify the injection of bezlotoxumab, with a dosage of 10 mg. It is important for medical coders to accurately assign this code when documenting and billing for the administration of bezlotoxumab.

2. Official Description

The official description of HCPCS code C9490 is “Injection, bezlotoxumab, 10 mg”. The short description for this code is “Parenteral supp not othrws c”. These descriptions provide a clear understanding of the procedure being performed and the specific dosage of bezlotoxumab being administered.

3. Procedure

1. Prepare the bezlotoxumab injection according to the manufacturer’s instructions.
2. Ensure proper patient identification and consent.
3. Select an appropriate injection site, such as the upper arm or thigh.
4. Cleanse the injection site with an antiseptic solution.
5. Administer the bezlotoxumab injection using a sterile syringe and needle.
6. Monitor the patient for any adverse reactions or complications.
7. Document the administration of bezlotoxumab in the patient’s medical record.

4. When to use HCPCS code C9490

HCPCS code C9490 should be used when documenting and billing for the injection of bezlotoxumab, with a dosage of 10 mg. It is important to ensure that the patient meets the specific criteria for receiving this medication and that the administration is performed by a qualified healthcare professional.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9490, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s medical necessity for receiving bezlotoxumab.
• Date and time of the injection.
• Dosage of bezlotoxumab administered.
• Any relevant patient information, such as allergies or previous adverse reactions.
• Provider’s signature and credentials.

6. Historical Information and Code Maintenance

HCPCS code C9490 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, 2017. The termination of this code means that it is no longer valid for use in documenting and billing for the injection of bezlotoxumab.

7. Medicare and Insurance Coverage

HCPCS code C9490 may have specific coverage instructions that apply, as indicated by the coverage code D. 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. Healthcare providers should consult the Medicare Carriers Manual Reference Section Number 2130 for further guidance on coverage and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C9490 should be billed:

1. A patient with a confirmed Clostridium difficile infection receives an injection of bezlotoxumab as part of their treatment plan.
2. A healthcare provider administers bezlotoxumab to a patient who has a high risk of recurrent Clostridium difficile infection.
3. A patient receives bezlotoxumab as a preventive measure after undergoing a gastrointestinal surgery.
4. A healthcare provider administers bezlotoxumab to a patient who has experienced multiple episodes of Clostridium difficile infection in the past.
5. A patient with a severe Clostridium difficile infection receives an injection of bezlotoxumab to help reduce the risk of recurrence.