How To Use HCPCS Code C9748

HCPCS code C9748 describes the procedure of transurethral destruction of prostate tissue using radiofrequency water vapor (steam) thermal therapy. 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 C9748, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and examples of when this code should be billed.

1. What is HCPCS C9748?

HCPCS code C9748 is a specific code used to identify the procedure of transurethral destruction of prostate tissue using radiofrequency water vapor (steam) thermal therapy. This procedure involves the use of radiofrequency energy to deliver thermal therapy to the prostate tissue, resulting in the destruction of the tissue. It is typically performed to treat benign prostatic hyperplasia (BPH), a condition characterized by the enlargement of the prostate gland.

2. Official Description

The official description of HCPCS code C9748 is “Transurethral destruction of prostate tissue; by radiofrequency water vapor (steam) thermal therapy.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The procedure of transurethral destruction of prostate tissue using radiofrequency water vapor (steam) thermal therapy begins with the insertion of a cystoscope into the urethra.
2. Once the cystoscope is in place, a small catheter is inserted through the cystoscope and into the urethra.
3. The catheter delivers radiofrequency energy in the form of water vapor (steam) to the prostate tissue.
4. The thermal therapy generated by the radiofrequency energy destroys the excess prostate tissue, relieving the symptoms of BPH.
5. After the procedure, the catheter is removed, and the patient is monitored for any complications or side effects.

4. When to use HCPCS code C9748

HCPCS code C9748 should be used when healthcare providers perform the transurethral destruction of prostate tissue using radiofrequency water vapor (steam) thermal therapy. This code is specific to this procedure and should not be used for other treatments or interventions. It is important to ensure that the patient meets the eligibility criteria for this procedure and that the procedure is medically necessary.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9748, healthcare providers need to document the details of the procedure, including the medical necessity, the patient’s diagnosis, and any supporting documentation. It is important to follow the specific billing guidelines provided by Medicare or other insurance carriers to ensure accurate and timely reimbursement. Providers should also include any additional documentation required by the payer, such as operative reports or clinical notes.

6. Historical Information and Code Maintenance

HCPCS code C9748 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, which means 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 other insurance carriers may provide coverage for HCPCS code C9748, subject to specific coverage instructions. It is important to review the Medicare Carriers Manual or other relevant guidelines to determine the coverage criteria and reimbursement rates for this procedure. Providers should also verify the coverage and reimbursement policies of other insurance carriers to ensure proper billing and reimbursement.

8. Examples

Here are five examples of when HCPCS code C9748 should be billed:

1. A 65-year-old male patient with a diagnosis of benign prostatic hyperplasia undergoes transurethral destruction of prostate tissue using radiofrequency water vapor thermal therapy.
2. A 70-year-old male patient with recurrent urinary symptoms due to benign prostatic hyperplasia receives transurethral destruction of prostate tissue using radiofrequency water vapor thermal therapy as a treatment option.
3. A 60-year-old male patient with a history of benign prostatic hyperplasia undergoes transurethral destruction of prostate tissue using radiofrequency water vapor thermal therapy after failed medical management.
4. A 55-year-old male patient with symptomatic benign prostatic hyperplasia undergoes transurethral destruction of prostate tissue using radiofrequency water vapor thermal therapy as an alternative to surgical intervention.
5. A 75-year-old male patient with urinary retention secondary to benign prostatic hyperplasia receives transurethral destruction of prostate tissue using radiofrequency water vapor thermal therapy to relieve the obstruction.