How To Use HCPCS Code C9507

HCPCS code C9507 describes the use of plasma with a high titer of COVID-19 convalescent antibodies. This code is used to identify the administration of this specific type of plasma, which is used as a treatment for patients who have contracted COVID-19. In this article, we will explore the details of HCPCS code C9507, 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 C9507?

HCPCS code C9507 is used to identify the administration of plasma with a high titer of COVID-19 convalescent antibodies. This plasma is derived from individuals who have recovered from COVID-19 and have developed a high level of antibodies against the virus. The administration of this plasma is considered a parenteral supply and is not otherwise classified. It is important to note that this code specifically refers to each unit of the plasma.

2. Official Description

The official description of HCPCS code C9507 is “Plasma, high titer COVID-19 convalescent, each unit.” This description accurately reflects the purpose of this code, which is to identify the administration of plasma with a high concentration of COVID-19 convalescent antibodies. The short description of this code is “Parenteral supply not otherwise classified.”

3. Procedure

1. The procedure for administering plasma with a high titer of COVID-19 convalescent antibodies involves several steps:

• Verify the patient’s eligibility for this treatment based on specific criteria set by the healthcare provider or insurer.
• Ensure that the plasma has been properly collected, processed, and stored according to established guidelines.
• Prepare the administration site and equipment, following standard aseptic techniques.
• Administer the plasma intravenously or through another appropriate route, as determined by the healthcare provider.
• Monitor the patient closely during and after the administration for any adverse reactions or complications.
• Document the details of the administration, including the date, time, dosage, and any relevant patient information.

4. When to use HCPCS code C9507

HCPCS code C9507 should be used when administering plasma with a high titer of COVID-19 convalescent antibodies to patients who meet the specific eligibility criteria. These criteria may vary depending on the healthcare provider or insurer, but typically include factors such as the severity of the patient’s COVID-19 infection, their immune response, and the availability of the plasma.

5. Billing Guidelines and Documentation Requirements

When billing for the administration of plasma with a high titer of COVID-19 convalescent antibodies using HCPCS code C9507, healthcare providers need to ensure that they document the necessary information to support the claim. This includes the patient’s medical record, which should include details such as the patient’s COVID-19 diagnosis, the rationale for using convalescent plasma, and any relevant test results. Additionally, providers should include the date, time, dosage, and route of administration in their documentation.

6. Historical Information and Code Maintenance

HCPCS code C9507 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has an effective date of January 01, 1996, and is priced under other carrier pricing methodology, as indicated by the pricing indicator code 57. The code does not have a multiple pricing indicator code, as it is not applicable.

7. Medicare and Insurance Coverage

HCPCS code C9507 is eligible for coverage by Medicare and other insurance providers. The specific coverage instructions may vary depending on the insurer, so it is important for healthcare providers to review the individual payer’s guidelines and policies. The pricing of this service or supply is determined by other carriers and is not applicable under one specific methodology.

8. Examples

Here are five examples of when HCPCS code C9507 should be billed:

1. A patient with severe COVID-19 infection receives plasma with a high titer of COVID-19 convalescent antibodies as part of their treatment plan.
2. A healthcare provider administers plasma with a high titer of COVID-19 convalescent antibodies to a patient who has a compromised immune system.
3. A patient who has tested positive for COVID-19 and is at high risk of developing severe symptoms receives plasma with a high titer of COVID-19 convalescent antibodies as a preventive measure.
4. A healthcare facility uses plasma with a high titer of COVID-19 convalescent antibodies for research purposes.
5. A patient who has recovered from COVID-19 and is experiencing a relapse receives plasma with a high titer of COVID-19 convalescent antibodies to boost their immune response.