How To Use HCPCS Code C9746

HCPCS code C9746 describes the procedure of transperineal implantation of a permanent adjustable balloon continence device, with cystourethroscopy and/or fluoroscopy when performed. 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 C9746, 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 C9746?

HCPCS code C9746 is a specific code used in medical coding to identify the procedure of transperineal implantation of a permanent adjustable balloon continence device, with cystourethroscopy and/or fluoroscopy when performed. This code is unique to this particular medical service and is used to accurately document and bill for this procedure.

2. Official Description

The official description of HCPCS code C9746 is “Transperineal implantation of permanent adjustable balloon continence device, with cystourethroscopy, when performed and/or fluoroscopy, when performed.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The procedure of HCPCS code C9746 involves the transperineal implantation of a permanent adjustable balloon continence device. This procedure is performed under the guidance of cystourethroscopy and/or fluoroscopy.
2. The healthcare provider begins by preparing the patient for the procedure, ensuring their comfort and safety.
3. A cystourethroscopy is performed to visualize the urinary tract and bladder. This allows the healthcare provider to accurately place the permanent adjustable balloon continence device.
4. If necessary, fluoroscopy may also be used during the procedure to provide real-time imaging guidance.
5. The healthcare provider then implants the permanent adjustable balloon continence device through the perineum, ensuring proper placement and functionality.
6. Once the procedure is complete, the healthcare provider ensures the patient’s comfort and provides any necessary post-procedure instructions.

4. When to use HCPCS code C9746

HCPCS code C9746 should be used when a healthcare provider performs the transperineal implantation of a permanent adjustable balloon continence device, with the assistance of cystourethroscopy and/or fluoroscopy. This code is specific to this procedure and should only be used when all the necessary components are met.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9746, healthcare providers should ensure that the necessary documentation is in place to support the medical necessity of the procedure. This may include the operative report, documentation of the use of cystourethroscopy and/or fluoroscopy, and any other relevant medical records. It is important to accurately code and document the procedure to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9746 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has a termination date of June 30, 2019. This code has no maintenance actions, as indicated by the action code N, which means no maintenance for this code. It is important for medical coders to stay updated on any changes or revisions to HCPCS codes to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

HCPCS code C9746 falls under the special coverage instructions category (HCPCS Coverage Code: D). 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. Medicare and other insurance coverage for HCPCS code C9746 may vary, and it is important to check with the specific payer for their reimbursement policies and guidelines.

8. Examples

Here are five examples of when HCPCS code C9746 should be billed:

1. A 65-year-old male patient with urinary incontinence undergoes transperineal implantation of a permanent adjustable balloon continence device with cystourethroscopy guidance.
2. A 50-year-old female patient with a history of pelvic floor dysfunction and urinary incontinence undergoes transperineal implantation of a permanent adjustable balloon continence device with fluoroscopy guidance.
3. A 70-year-old male patient with post-prostatectomy incontinence undergoes transperineal implantation of a permanent adjustable balloon continence device with both cystourethroscopy and fluoroscopy guidance.
4. A 55-year-old female patient with a history of multiple failed conservative treatments for urinary incontinence undergoes transperineal implantation of a permanent adjustable balloon continence device with cystourethroscopy and fluoroscopy guidance.
5. A 60-year-old male patient with neurogenic bladder dysfunction undergoes transperineal implantation of a permanent adjustable balloon continence device with cystourethroscopy guidance.