How To Use HCPCS Code C9492

HCPCS code C9492 describes the injection of durvalumab, with a dosage of 10 mg. This code is used to identify the administration of this specific medication in a parenteral form. In this article, we will explore the details of HCPCS code C9492, 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 C9492?

HCPCS code C9492 is used to identify the injection of durvalumab, a medication with a dosage of 10 mg. This code specifically refers to the parenteral administration of durvalumab, which means it is administered through a route other than the digestive tract, such as intravenous, intramuscular, or subcutaneous injection.

2. Official Description

The official description of HCPCS code C9492 is “Injection, durvalumab, 10 mg”. This description accurately represents the specific medication and dosage that this code refers to. The short description for this code is “Parenteral supp not othrws c”, indicating that it is a parenteral supply that does not fall under any other category.

3. Procedure

1. Prepare the durvalumab injection according to the manufacturer’s instructions.
2. Verify the patient’s identity and confirm the correct dosage of 10 mg.
3. Select an appropriate injection site, such as a vein, muscle, or subcutaneous tissue.
4. Ensure proper aseptic technique by cleaning the injection site with an antiseptic solution.
5. Administer the durvalumab injection using the appropriate technique for the chosen route of administration.
6. Monitor the patient for any adverse reactions or complications following the injection.

4. When to use HCPCS code C9492

HCPCS code C9492 should be used when administering durvalumab in a parenteral form, specifically with a dosage of 10 mg. It is important to ensure that the administration of durvalumab meets the specific criteria outlined by the code description. This code should not be used for other medications or dosages.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9492, healthcare providers should ensure that the following documentation is included:

• Documentation of the patient’s identity and medical record number.
• Documentation of the specific dosage of durvalumab administered (10 mg).
• Documentation of the route of administration (e.g., intravenous, intramuscular, subcutaneous).
• Documentation of any complications or adverse reactions observed during or after the injection.

6. Historical Information and Code Maintenance

HCPCS code C9492 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has been terminated since December 31, 2018. The termination of this code means that it is no longer valid for billing purposes. 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

HCPCS code C9492 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. The Medicare Carriers Manual Reference Section Number for this code is 2130.

8. Examples

Here are some examples of when HCPCS code C9492 should be billed:

1. A patient with lung cancer receives a 10 mg injection of durvalumab intravenously as part of their chemotherapy treatment.
2. A patient with bladder cancer receives a 10 mg injection of durvalumab intramuscularly as part of their immunotherapy regimen.
3. A patient with skin cancer receives a 10 mg injection of durvalumab subcutaneously as part of their targeted therapy.
4. A patient with lymphoma receives a 10 mg injection of durvalumab intravenously as part of their combination therapy.
5. A patient with breast cancer receives a 10 mg injection of durvalumab subcutaneously as part of their adjuvant treatment.