How To Use HCPCS Code C9756

HCPCS code C9756 describes the procedure of intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG). This code is used to identify a specific medical service that involves the use of near-infrared fluorescence imaging to map the lymphatic system during surgery. It is important for medical coders to understand the meaning and usage of this code in order to accurately report and bill for this procedure.

1. What is HCPCS C9756?

HCPCS code C9756 is a specific code that represents the procedure of intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) with the administration of indocyanine green. This procedure involves the use of near-infrared fluorescence imaging to identify and map the lymphatic system during surgery. It is typically performed to locate and assess the lymph nodes that are either sentinel nodes or tumor-draining nodes.

2. Official Description

The official description of HCPCS code C9756 is “Intraoperative near-infrared fluorescence lymphatic mapping of lymph node(s) (sentinel or tumor draining) with administration of indocyanine green (ICG) (list separately in addition to code for primary procedure)”. The short description for this code is “Enteral supp not otherwise c”.

3. Procedure

1. The procedure of intraoperative near-infrared fluorescence lymphatic mapping with indocyanine green administration involves several steps:
2. The patient is prepared for surgery and brought into the operating room.
3. The surgeon identifies the lymph nodes that need to be mapped, either sentinel nodes or tumor-draining nodes.
4. A solution of indocyanine green (ICG) is prepared and injected into the patient’s lymphatic system.
5. A near-infrared fluorescence imaging system is used to visualize the lymphatic system and map the lymph nodes.
6. The surgeon identifies and marks the lymph nodes based on the fluorescence imaging.
7. The procedure continues with the primary surgical intervention, which may involve the removal of lymph nodes or other related procedures.

4. When to use HCPCS code C9756

HCPCS code C9756 should be used when performing the intraoperative near-infrared fluorescence lymphatic mapping procedure with indocyanine green administration. This code is specifically used for cases where the lymph nodes being mapped are either sentinel nodes or tumor-draining nodes. It is important to accurately document and report the use of this code when it is applicable to ensure proper reimbursement and tracking of this specialized procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9756, healthcare providers need to ensure that the following documentation requirements are met:

• Documentation of the specific procedure performed, including the use of near-infrared fluorescence imaging and the administration of indocyanine green.
• Documentation of the indication for the procedure, such as the presence of sentinel nodes or tumor-draining nodes.
• Documentation of the medical necessity for the procedure and its relevance to the overall surgical intervention.

6. Historical Information and Code Maintenance

HCPCS code C9756 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code has been in use for several years and has remained unchanged since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code C9756 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 procedure.

8. Examples

Here are five examples of when HCPCS code C9756 should be billed:

1. A patient undergoes breast cancer surgery, and the surgeon performs intraoperative near-infrared fluorescence lymphatic mapping with indocyanine green administration to identify and remove sentinel lymph nodes.
2. A patient with melanoma requires lymph node dissection, and the surgeon utilizes near-infrared fluorescence imaging with indocyanine green to map and locate the tumor-draining lymph nodes.
3. A patient with head and neck cancer undergoes surgery, and the surgeon uses near-infrared fluorescence lymphatic mapping with indocyanine green to identify and assess the lymph nodes involved in the tumor drainage.
4. A patient with gynecological cancer requires lymph node evaluation, and the surgeon performs intraoperative near-infrared fluorescence lymphatic mapping with indocyanine green to locate and remove the sentinel nodes.
5. A patient with colorectal cancer undergoes surgery, and the surgeon utilizes near-infrared fluorescence imaging with indocyanine green to map and assess the lymph nodes involved in the tumor drainage.