How To Use HCPCS Code C9753

HCPCS code C9753 describes the destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), specifically in the lumbar/sacrum region. This code is used to identify a procedure that involves the destruction of the basivertebral nerve within the bone, which can provide relief for patients suffering from chronic back pain. In this article, we will explore the details of HCPCS code C9753, 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 C9753?

HCPCS code C9753 is a specific code used to identify the destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance, in the lumbar/sacrum region. This procedure involves the use of imaging guidance, such as fluoroscopy, to accurately target and destroy the basivertebral nerve within the bone. It is typically performed to alleviate chronic back pain in patients who have not responded to other conservative treatments.

2. Official Description

The official description of HCPCS code C9753 is “Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure).” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The provider begins by preparing the patient for the procedure, ensuring their comfort and safety.
2. Imaging guidance, such as fluoroscopy, is used to visualize the lumbar/sacrum region and identify the target area.
3. A small incision is made in the skin overlying the target vertebral body.
4. A specialized instrument is inserted through the incision and guided to the basivertebral nerve within the bone.
5. The basivertebral nerve is then destroyed using an appropriate technique, such as radiofrequency ablation or cryoablation.
6. The instrument is carefully removed, and the incision is closed with sutures or adhesive strips.
7. The patient is monitored for any immediate post-procedure complications and provided with appropriate post-operative care instructions.

4. When to use HCPCS code C9753

HCPCS code C9753 should be used when the provider performs the destruction of the intraosseous basivertebral nerve in each additional vertebral body, specifically in the lumbar/sacrum region. This procedure is typically performed as an adjunct to a primary procedure and should be listed separately in addition to the code for the primary procedure. It is important to ensure that the patient meets the necessary eligibility criteria and that the procedure is medically necessary for the management of chronic back pain.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9753, healthcare providers should ensure that the necessary documentation is in place to support the medical necessity of the procedure. This may include clinical notes, imaging reports, and any other relevant documentation. It is also important to follow the specific billing guidelines set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement. Providers should use the appropriate modifiers, if required, to indicate any additional procedures or services performed in conjunction with the destruction of the basivertebral nerve.

6. Historical Information and Code Maintenance

HCPCS code C9753 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 1996. As of December 31, 2021, this code has been terminated. The termination of a code indicates that it is no longer valid for use in medical billing and coding. It is important for healthcare providers to stay updated on any changes or revisions to HCPCS codes to ensure accurate coding and billing practices.

7. Medicare and Insurance Coverage

HCPCS code C9753 is covered by Medicare and other insurance carriers. 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. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C9753 should be billed:

1. A 55-year-old patient with chronic lower back pain undergoes a lumbar fusion surgery. During the procedure, the provider also performs the destruction of the basivertebral nerve in each additional vertebral body using imaging guidance.
2. A 60-year-old patient with degenerative disc disease and persistent back pain undergoes a minimally invasive lumbar decompression procedure. The provider performs the destruction of the basivertebral nerve in each additional vertebral body as an adjunct to the primary procedure.
3. A 45-year-old patient with a history of failed back surgery syndrome undergoes a revision lumbar fusion surgery. The provider performs the destruction of the basivertebral nerve in each additional vertebral body to address the patient’s ongoing back pain.
4. A 50-year-old patient with chronic lumbar radiculopathy undergoes a lumbar laminectomy procedure. The provider performs the destruction of the basivertebral nerve in each additional vertebral body to provide additional pain relief.
5. A 65-year-old patient with severe osteoporosis and vertebral compression fractures undergoes a kyphoplasty procedure. The provider performs the destruction of the basivertebral nerve in each additional vertebral body to manage the patient’s pain and improve their quality of life.