How To Use HCPCS Code C9747

HCPCS code C9747 describes the procedure of ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance. This code is used to identify and bill for this specific medical service. In this article, we will explore the details of HCPCS code C9747, 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 C9747?

HCPCS code C9747 is a specific code used to identify the procedure of ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance. It is important to use this code accurately to ensure proper documentation and billing for this service.

2. Official Description

The official description of HCPCS code C9747 is “Ablation of prostate, transrectal, high intensity focused ultrasound (HIFU), including imaging guidance.” This description precisely defines the procedure that this code represents. The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure of ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance involves several steps:
2. The patient is positioned appropriately for the procedure, usually lying on their back with their legs supported.
3. A transrectal ultrasound probe is inserted into the rectum to visualize the prostate gland.
4. Imaging guidance is used to precisely target the areas of the prostate that require ablation.
5. High intensity focused ultrasound (HIFU) energy is then delivered to the targeted areas, causing thermal destruction of the prostate tissue.
6. The procedure is monitored and adjusted as necessary to ensure optimal treatment outcomes.
7. After the ablation is complete, the ultrasound probe is removed, and the patient is monitored for any immediate post-procedure complications.

4. When to use HCPCS code C9747

HCPCS code C9747 should be used when performing the specific procedure of ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance. It is important to ensure that the procedure meets the criteria outlined in the code description to accurately use this code for documentation and billing purposes.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9747, healthcare providers need to ensure proper documentation of the procedure performed, including the use of transrectal high intensity focused ultrasound (HIFU) with imaging guidance. It is essential to include all relevant details in the medical record to support the medical necessity of the procedure and justify the use of this specific HCPCS code.

6. Historical Information and Code Maintenance

HCPCS code C9747 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. 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, meaning it is not applicable as HCPCS priced under one methodology. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9747 may vary. It is important to check with the specific payer to determine if this code is payable. The Medicare Carriers Manual Reference Section Number for this code is 2130, which provides additional guidance on coverage and reimbursement. Providers should also consider the pricing indicator code and multiple pricing indicator code when determining how this service or supply is priced by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code C9747 should be billed:

1. A 65-year-old male patient with localized prostate cancer undergoes ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance.
2. A 70-year-old male patient with benign prostatic hyperplasia (BPH) undergoes ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance.
3. A 60-year-old male patient with recurrent prostate cancer undergoes ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance.
4. A 55-year-old male patient with prostate gland enlargement undergoes ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance.
5. A 75-year-old male patient with localized prostate cancer and contraindications to surgery undergoes ablation of the prostate using transrectal high intensity focused ultrasound (HIFU) with imaging guidance.