How To Use HCPCS Code C9743

HCPCS code C9743 describes the injection or implantation of bulking or spacer material, with or without image guidance. This code is used to identify a specific procedure that involves the use of a bulking or spacer material to treat certain medical conditions. It is important for medical coders to understand the meaning and usage of this code in order to accurately report and bill for this procedure.

1. What is HCPCS C9743?

HCPCS code C9743 is a specific code that is used to identify the injection or implantation of bulking or spacer material. This procedure involves the use of a material, such as collagen or silicone, to create a bulking effect or provide space in a specific area of the body. The injection or implantation may be performed with or without image guidance, depending on the specific circumstances and the provider’s preference.

2. Official Description

The official description of HCPCS code C9743 is “Injection/implantation of bulking or spacer material (any type) with or without image guidance (not to be used if a more specific code applies).” The short description for this code is “Parenteral supp not othrws c.” It is important to use the official description and short description exactly as provided when reporting this code.

3. Procedure

1. The provider begins by preparing the bulking or spacer material for injection or implantation. This may involve mixing or preparing the material according to the manufacturer’s instructions.
2. The provider then identifies the specific area of the body where the injection or implantation will take place. This may involve using imaging guidance, such as ultrasound or fluoroscopy, to ensure accurate placement of the material.
3. Using a sterile technique, the provider injects or implants the bulking or spacer material into the targeted area. The specific technique and equipment used may vary depending on the type of material being used and the provider’s preference.
4. After the injection or implantation, the provider may use imaging guidance to confirm the placement of the material and ensure that it is in the desired location.
5. The procedure is typically completed with the application of a sterile dressing or bandage to the injection or implantation site.

4. When to use HCPCS code C9743

HCPCS code C9743 should be used when the provider performs the injection or implantation of bulking or spacer material. This code is applicable for a wide range of medical conditions where the use of such material is necessary to achieve the desired therapeutic effect. It is important to note that this code should not be used if a more specific code applies to the procedure being performed.

5. Billing Guidelines and Documentation Requirements

When reporting HCPCS code C9743, healthcare providers should ensure that they accurately document the details of the procedure, including the type of material used, the specific area of the body where the injection or implantation took place, and any imaging guidance that was utilized. It is also important to include any relevant clinical information that supports the medical necessity of the procedure. When billing for this service, providers should follow the appropriate coding and billing guidelines set forth by Medicare or other insurance carriers.

6. Historical Information and Code Maintenance

HCPCS code C9743 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has a termination date of June 30, 2016. This code has 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 that it is not applicable as HCPCS priced under one methodology. It is important for medical coders to stay updated on any changes or revisions to this code, as well as any specific guidelines or instructions that may apply.

7. Medicare and Insurance Coverage

HCPCS code C9743 may be covered by Medicare and other insurance carriers, but it is important to verify coverage and reimbursement policies with the specific payer. The Medicare Carriers Manual Reference Section Number for this code is 2130, which provides additional information and guidance for reporting and billing this procedure. Providers should follow the pricing and reimbursement guidelines set forth by Medicare or other insurance carriers when submitting claims for this service.

8. Examples

Here are five examples of when HCPCS code C9743 should be billed:

1. A patient with urinary incontinence undergoes an injection of bulking material into the urethra to improve bladder control.
2. A patient with vocal cord paralysis receives an injection of bulking material into the vocal cords to improve voice quality and function.
3. A patient with fecal incontinence undergoes an implantation of a spacer material in the anal canal to provide support and improve bowel control.
4. A patient with facial asymmetry receives an injection of bulking material into the cheeks to restore volume and improve facial symmetry.
5. A patient with gastroesophageal reflux disease undergoes an implantation of a spacer material in the lower esophageal sphincter to prevent acid reflux.