How To Use HCPCS Code C9740

HCPCS code C9740 describes the procedure of cystourethroscopy with the insertion of transprostatic implants. This code is used to identify a specific medical service provided by healthcare providers. In this article, we will explore the details of HCPCS code C9740, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples.

1. What is HCPCS C9740?

HCPCS code C9740 is a specific code used to identify the procedure of cystourethroscopy with the insertion of transprostatic implants. This code is essential for medical coders and billers to accurately document and bill for this particular service.

2. Official Description

The official description of HCPCS code C9740 is “Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants.” The short description for this code is “Enteral supp not otherwise c.” It is important to use the exact official description when assigning this code to ensure proper documentation and billing.

3. Procedure

1. The procedure of cystourethroscopy with the insertion of transprostatic implants involves the use of a cystoscope, a thin tube with a camera and light, to examine the bladder and urethra.
2. The healthcare provider inserts the cystoscope into the urethra and advances it into the bladder.
3. Once the bladder is visualized, the provider inserts transprostatic implants, specifically four or more implants, into the prostate gland.
4. The implants are typically used to treat conditions such as benign prostatic hyperplasia (BPH) or other prostate-related issues.
5. Throughout the procedure, the provider carefully monitors the patient’s condition and ensures the proper placement of the implants.
6. After the procedure is complete, the cystoscope is removed, and the patient is monitored for any potential complications.

4. When to use HCPCS code C9740

HCPCS code C9740 should be used when the healthcare provider performs a cystourethroscopy procedure and inserts four or more transprostatic implants. It is important to review the specific documentation and guidelines to ensure the accurate use of this code.

5. Billing Guidelines and Documentation Requirements

When billing for the procedure described by HCPCS code C9740, healthcare providers need to document the details of the cystourethroscopy, including the number of transprostatic implants inserted. Additionally, proper documentation should include the medical necessity for the procedure and any relevant patient information.

6. Historical Information and Code Maintenance

HCPCS code C9740 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code C9740 falls under the special coverage instructions category, denoted by the coverage code D. This indicates that specific coverage instructions apply to this code. The pricing indicator code for this code is 57, which signifies that it is priced by other carriers. The multiple pricing indicator code A indicates that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9740 should be billed:

1. A 65-year-old male patient with benign prostatic hyperplasia (BPH) undergoes cystourethroscopy with the insertion of six transprostatic implants.
2. A 55-year-old female patient with recurrent urinary tract infections undergoes cystourethroscopy with the insertion of five transprostatic implants.
3. A 70-year-old male patient with urinary retention undergoes cystourethroscopy with the insertion of four transprostatic implants.
4. A 60-year-old female patient with bladder stones undergoes cystourethroscopy with the insertion of seven transprostatic implants.
5. A 75-year-old male patient with lower urinary tract symptoms undergoes cystourethroscopy with the insertion of six transprostatic implants.