How To Use HCPCS Code C9728

HCPCS code C9728 describes the placement of interstitial device(s) for radiation therapy/surgery guidance. This code is used for procedures involving the placement of fiducial markers, dosimeters, or other interstitial devices to assist in the delivery of radiation therapy or surgery. It is important for medical coders to understand the specific details and guidelines for using this code to ensure accurate billing and reimbursement.

1. What is HCPCS C9728?

HCPCS code C9728 is used to identify the placement of interstitial device(s) for radiation therapy/surgery guidance. This includes the placement of fiducial markers, dosimeters, or other interstitial devices that are used to guide the delivery of radiation therapy or surgery. The code is specific to procedures performed on sites other than the abdomen, pelvis, prostate, retroperitoneum, or thorax, using any approach. It is important to note that this code is not applicable for procedures performed on the aforementioned sites.

2. Official Description

The official description of HCPCS code C9728 is “Placement of interstitial device(s) for radiation therapy/surgery guidance (e.g., fiducial markers, dosimeter), for other than the following sites (any approach): abdomen, pelvis, prostate, retroperitoneum, thorax, single or multiple.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The provider begins by identifying the specific site where the interstitial device(s) will be placed for radiation therapy/surgery guidance.
2. The provider prepares the patient for the procedure, ensuring that the patient is in the appropriate position and that the area to be treated is properly exposed.
3. The provider uses imaging techniques, such as ultrasound, CT scan, or MRI, to guide the placement of the interstitial device(s) accurately.
4. The provider makes a small incision or puncture at the site of placement.
5. The provider inserts the interstitial device(s) into the targeted tissue or organ, ensuring proper positioning.
6. The provider may use imaging techniques during the procedure to confirm the correct placement of the interstitial device(s).
7. Once the interstitial device(s) are in place, the provider may secure them using sutures or other appropriate methods.
8. The provider documents the details of the procedure, including the specific interstitial device(s) used, the site of placement, and any complications or additional procedures performed.

4. When to use HCPCS code C9728

HCPCS code C9728 should be used when the provider performs the placement of interstitial device(s) for radiation therapy/surgery guidance on sites other than the abdomen, pelvis, prostate, retroperitoneum, or thorax. It is important to ensure that the procedure meets the specific criteria outlined in the code description to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9728, healthcare providers should ensure that the documentation supports the medical necessity and appropriateness of the procedure. The documentation should include the following:

• Documentation of the specific interstitial device(s) used
• Documentation of the site of placement
• Documentation of any complications or additional procedures performed
• Supporting imaging reports, if applicable

Providers should also follow the billing guidelines set forth by the payer, ensuring that all necessary information is included on the claim form.

6. Historical Information and Code Maintenance

HCPCS code C9728 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions 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 C9728 is assigned a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means it is not applicable as HCPCS priced under one methodology. Medicare and other insurance coverage for HCPCS code C9728 may vary, and it is important for healthcare providers to check with the specific payer for coverage and reimbursement guidelines.

8. Examples

Here are five examples of when HCPCS code C9728 should be billed:

1. A patient undergoes radiation therapy for a tumor located in the arm. The provider places fiducial markers to guide the delivery of radiation therapy.
2. A patient requires radiation therapy for a tumor in the leg. The provider inserts dosimeters to monitor the radiation dose delivered to the tumor.
3. A patient undergoes surgery for a tumor in the head and neck region. The provider places interstitial devices to guide the surgical resection of the tumor.
4. A patient requires radiation therapy for a tumor in the hand. The provider inserts fiducial markers to ensure accurate targeting of the tumor during treatment.
5. A patient undergoes surgery for a tumor in the foot. The provider places dosimeters to monitor the radiation dose delivered to the tumor during the surgical procedure.