How To Use HCPCS Code C9724

HCPCS code C9724 describes the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS). This code includes the endoscopy procedure and was terminated on December 31, 2015. In this article, we will explore the details of HCPCS code C9724, 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 C9724?

HCPCS code C9724 is used to identify the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS). This procedure involves the use of an endoscope to create folds in the stomach wall, which helps reduce its size and restrict food intake. It is typically performed as a treatment for obesity or weight loss management.

2. Official Description

The official description of HCPCS code C9724 is “Endoscopic full-thickness plication of the stomach using endoscopic plication system (EPS); includes endoscopy.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The patient is prepared for the procedure, which may include fasting and the administration of sedation or anesthesia.
2. An endoscope, a flexible tube with a light and camera, is inserted through the mouth and into the stomach.
3. The endoscope allows the healthcare provider to visualize the stomach and perform the plication procedure.
4. Using the endoscopic plication system (EPS), the provider creates folds in the stomach wall by suturing or folding the tissue.
5. The number and location of the plications may vary depending on the patient’s condition and desired outcome.
6. Once the plication procedure is completed, the endoscope is removed, and the patient is monitored for any complications.

4. When to use HCPCS code C9724

HCPCS code C9724 should be used when documenting and billing for the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS). This code is specifically for procedures performed before December 31, 2015. It is important to review the specific documentation and guidelines provided by payers to ensure proper usage of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9724, healthcare providers should ensure that the documentation supports the performance of the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS). The medical record should include details of the procedure, such as the approach used, the number and location of the plications, and any complications or additional services provided. Proper coding and documentation are essential for accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9724 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It had an effective date of January 1, 1996. No maintenance actions have been taken for this code, as indicated by the action code N, which means no maintenance for this code. It was terminated on December 31, 2015.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9724 may vary. 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. It is important to check with individual payers to determine coverage and reimbursement policies for this procedure.

8. Examples

Here are five examples of when HCPCS code C9724 should be billed:

1. A patient with morbid obesity undergoes an endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS) to aid in weight loss management.
2. An individual with a history of failed diet and exercise attempts undergoes the procedure to reduce the size of their stomach and improve weight loss outcomes.
3. A healthcare provider performs the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS) as part of a clinical trial or research study.
4. A patient with a specific medical condition that requires weight loss undergoes the procedure to improve their overall health and well-being.
5. An individual who has previously undergone bariatric surgery but experienced weight regain undergoes the endoscopic full-thickness plication of the stomach using an endoscopic plication system (EPS) as a revision procedure.