How To Use HCPCS Code C9737

HCPCS code C9737 describes a specific surgical procedure known as laparoscopy with esophageal sphincter augmentation using a device, such as a magnetic band. This code is used to identify and bill for this particular procedure when performed by a healthcare provider. In this article, we will explore the details of HCPCS code C9737, 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 C9737?

HCPCS code C9737 is a specific code used to identify the laparoscopic surgical procedure of esophageal sphincter augmentation with a device, such as a magnetic band. This code is unique to this particular procedure and is used for billing and documentation purposes.

2. Official Description

The official description of HCPCS code C9737 is “Laparoscopy, surgical, esophageal sphincter augmentation with device (e.g., magnetic band)”. The short description for this code is “Parenteral supp not othrws c”. These descriptions accurately define the procedure and its purpose.

3. Procedure

1. The laparoscopic esophageal sphincter augmentation procedure begins with the patient under general anesthesia.
2. The surgeon makes small incisions in the abdomen to insert the laparoscope and other surgical instruments.
3. The surgeon then places the device, such as a magnetic band, around the esophageal sphincter to augment its function.
4. The procedure is performed using minimally invasive techniques, allowing for faster recovery and reduced scarring.
5. After the device is placed, the surgeon ensures its proper positioning and functionality.
6. The incisions are closed, and the patient is monitored during the recovery period.

4. When to use HCPCS code C9737

HCPCS code C9737 should be used when the laparoscopic esophageal sphincter augmentation procedure with a device, such as a magnetic band, is performed. It is important to ensure that the procedure meets the specific criteria outlined in the code description to accurately use this code for billing and documentation purposes.

5. Billing Guidelines and Documentation Requirements

When billing for the laparoscopic esophageal sphincter augmentation procedure using HCPCS code C9737, healthcare providers need to document the details of the procedure, including the use of the specific device, any complications encountered, and the patient’s medical necessity for the procedure. Proper documentation is essential for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9737 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has a termination date of June 30, 2015. This code has no maintenance actions associated with it, as indicated by the action code N, which means no maintenance for this code. It is important to note the historical context and termination date of the code when using it for billing purposes.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9737 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 Medicare and other insurance providers to determine coverage and reimbursement rates for this specific procedure.

8. Examples

Here are five examples of when HCPCS code C9737 should be billed:

1. A patient with gastroesophageal reflux disease (GERD) undergoes laparoscopic esophageal sphincter augmentation with a magnetic band to improve sphincter function.
2. A patient with a history of chronic heartburn and regurgitation undergoes laparoscopic esophageal sphincter augmentation with a device to alleviate symptoms.
3. A patient with a diagnosed hiatal hernia undergoes laparoscopic esophageal sphincter augmentation with a magnetic band to prevent reflux and hernia recurrence.
4. A patient with persistent symptoms of GERD despite medication management undergoes laparoscopic esophageal sphincter augmentation with a device as an alternative treatment option.
5. A patient with a history of failed previous anti-reflux surgeries undergoes laparoscopic esophageal sphincter augmentation with a magnetic band to address ongoing symptoms.