How To Use HCPCS Code C9493

HCPCS code C9493 describes the injection of edaravone, 1 mg. This code is used to identify the administration of edaravone, a medication used to treat amyotrophic lateral sclerosis (ALS) and other neurodegenerative diseases. In this article, we will explore the details of HCPCS code C9493, 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 C9493?

HCPCS code C9493 is a specific code used to identify the injection of edaravone, 1 mg. It is important to note that this code is specific to the administration of edaravone and should not be used for any other medications or procedures.

2. Official Description

The official description of HCPCS code C9493 is “Injection, edaravone, 1 mg.” This description accurately reflects the purpose of this code, which is to identify the administration of edaravone.

3. Procedure

1. Prepare the edaravone 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 injection site, such as the upper arm or thigh.
4. Cleanse the injection site with an antiseptic solution.
5. Administer the edaravone injection using a sterile syringe and needle.
6. Dispose of the used syringe and needle in a sharps container.
7. Document the administration of edaravone in the patient’s medical record.

4. When to use HCPCS code C9493

HCPCS code C9493 should be used when administering edaravone, 1 mg, to a patient. It is important to ensure that the patient meets the appropriate eligibility criteria for receiving this medication, as determined by the prescribing physician or healthcare provider.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of edaravone using HCPCS code C9493, healthcare providers should ensure that the following documentation requirements are met:

• Documentation of the patient’s medical necessity for receiving edaravone.
• Documentation of the dosage administered (1 mg).
• Documentation of the date and time of administration.
• Documentation of the injection site.
• Documentation of any adverse reactions or complications, if applicable.

6. Historical Information and Code Maintenance

HCPCS code C9493 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 1996. This code is terminated as of December 31, 2018. 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 C9493 is covered by Medicare and other insurance providers. 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.

8. Examples

Here are five examples of when HCPCS code C9493 should be billed:

1. A patient with a confirmed diagnosis of ALS receives an injection of edaravone, 1 mg, during their scheduled clinic visit.
2. A neurologist administers an edaravone injection, 1 mg, to a patient with a neurodegenerative disease other than ALS.
3. A home healthcare nurse administers an edaravone injection, 1 mg, to a bedridden patient with ALS in their home.
4. A patient receives an edaravone injection, 1 mg, as part of a clinical trial for a new treatment for neurodegenerative diseases.
5. A patient receives an edaravone injection, 1 mg, in a hospital setting following a stroke.