How To Use HCPCS Code C9734

HCPCS code C9734 describes a focused ultrasound ablation/therapeutic intervention procedure that is guided by magnetic resonance (MR) imaging. This code is used to identify a specific type of treatment that is performed using focused ultrasound waves to target and destroy abnormal tissue in the body, excluding uterine leiomyomata. In this article, we will explore the details of HCPCS code C9734, 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 C9734?

HCPCS code C9734 is a unique alphanumeric code that is used to identify a specific medical procedure or service. In the case of C9734, it represents a focused ultrasound ablation/therapeutic intervention procedure that is guided by magnetic resonance imaging. This procedure involves the use of focused ultrasound waves to target and destroy abnormal tissue in the body, excluding uterine leiomyomata. It is important to note that HCPCS codes are used primarily for billing and reimbursement purposes.

2. Official Description

The official description of HCPCS code C9734 is “Focused ultrasound ablation/therapeutic intervention, other than uterine leiomyomata, with magnetic resonance (MR) guidance.” This description accurately reflects the nature of the procedure and the guidance method used.

3. Procedure

1. The provider begins by positioning the patient on the examination table.
2. Magnetic resonance imaging (MRI) is used to identify the target tissue and guide the procedure.
3. A focused ultrasound device is then used to deliver high-intensity ultrasound waves to the target tissue.
4. The ultrasound waves generate heat, which destroys the abnormal tissue.
5. The provider monitors the procedure using real-time MRI imaging to ensure accurate targeting and treatment.
6. After the procedure is complete, the patient is monitored for any immediate complications or side effects.

4. When to use HCPCS code C9734

HCPCS code C9734 should be used when performing a focused ultrasound ablation/therapeutic intervention procedure that is guided by magnetic resonance imaging, excluding cases involving uterine leiomyomata. It is important to review the specific documentation and guidelines provided by payers to ensure proper use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9734, healthcare providers should ensure that the necessary documentation is in place to support the medical necessity and appropriateness of the procedure. This may include the following:

• Documentation of the patient’s medical history and condition
• Documentation of the targeted tissue and the rationale for the procedure
• Documentation of the use of magnetic resonance imaging for guidance
• Documentation of the procedure details, including the equipment used and any complications encountered

6. Historical Information and Code Maintenance

HCPCS code C9734 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. It is important to stay updated with any changes or revisions to the code that may occur in the future.

7. Medicare and Insurance Coverage

HCPCS code C9734 is assigned a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Medicare coverage for this procedure may vary depending on the specific circumstances and guidelines set by the Centers for Medicare and Medicaid Services (CMS). It is important to consult the Medicare Carriers Manual or other relevant references for detailed information on coverage and reimbursement.

8. Examples

Here are five examples of scenarios where HCPCS code C9734 may be billed:

1. A patient with a liver tumor undergoes a focused ultrasound ablation procedure guided by magnetic resonance imaging.
2. A patient with a pancreatic lesion receives a therapeutic intervention using focused ultrasound waves under magnetic resonance guidance.
3. A patient with a renal tumor undergoes a targeted ablation procedure using focused ultrasound waves with real-time MRI monitoring.
4. A patient with a bone metastasis receives a focused ultrasound ablation treatment guided by magnetic resonance imaging.
5. A patient with a soft tissue tumor undergoes a therapeutic intervention using focused ultrasound waves under the guidance of magnetic resonance imaging.