How To Use HCPCS Code C9749

HCPCS code C9749 describes the repair of nasal vestibular lateral wall stenosis with implant(s). This code is used to identify a specific procedure performed by healthcare providers to correct a narrowing or constriction of the nasal vestibular lateral wall using implants. In this article, we will explore the details of HCPCS code C9749, 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 C9749?

HCPCS code C9749 is a specific code used in medical coding to identify the repair of nasal vestibular lateral wall stenosis with implant(s). It is important for medical coders to accurately assign this code to ensure proper documentation and billing for the procedure.

2. Official Description

The official description of HCPCS code C9749 is “Repair of nasal vestibular lateral wall stenosis with implant(s)”. The short description for this code is “Parenteral supp not othrws c”. It is essential to use the exact official and short descriptions when assigning this code.

3. Procedure

1. The repair of nasal vestibular lateral wall stenosis with implant(s) involves a surgical procedure performed by a healthcare provider.
2. The provider will first assess the patient’s condition and determine the extent of the stenosis.
3. A small incision is made in the nasal vestibule to access the affected area.
4. The provider will then use implants, such as grafts or prosthetic materials, to repair and reconstruct the nasal vestibular lateral wall.
5. The implants are carefully placed to restore proper function and alleviate the stenosis.
6. After the procedure, the incision is closed, and appropriate post-operative care is provided to the patient.

4. When to use HCPCS code C9749

HCPCS code C9749 should be used when a healthcare provider performs the repair of nasal vestibular lateral wall stenosis with implant(s). This code is specific to this particular procedure and should not be used for other nasal or sinus-related conditions or treatments.

5. Billing Guidelines and Documentation Requirements

When billing for the repair of nasal vestibular lateral wall stenosis with implant(s) using HCPCS code C9749, healthcare providers need to ensure proper documentation of the procedure. This includes detailed information about the patient’s condition, the surgical technique used, the type and placement of implants, and any other relevant details. Additionally, providers should follow the billing guidelines set forth by the relevant insurance carriers to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9749 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 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 C9749 is A, indicating that it is not applicable as HCPCS priced under one methodology. It is important for medical coders to stay updated on any maintenance actions or revisions related to this code.

7. Medicare and Insurance Coverage

HCPCS code C9749 falls under the special coverage instructions category (Coverage Code: D), which means that specific coverage instructions apply. Medicare and other insurance carriers may have their own guidelines and policies regarding coverage for this procedure. It is crucial for healthcare providers to verify coverage with the respective payers and follow the necessary documentation and billing requirements.

8. Examples

Here are five examples of scenarios where HCPCS code C9749 should be billed:

1. A patient presents with severe nasal vestibular lateral wall stenosis and undergoes a surgical repair using implants.
2. A healthcare provider performs a revision surgery for a patient who previously had a repair of nasal vestibular lateral wall stenosis with implants.
3. A patient with nasal vestibular lateral wall stenosis undergoes a repair procedure using multiple implants.
4. A healthcare provider performs a repair of nasal vestibular lateral wall stenosis with implants on a patient with a history of chronic sinusitis.
5. A patient with nasal vestibular lateral wall stenosis undergoes a repair procedure using a specific type of implant recommended for their condition.