How To Use HCPCS Code C9763

HCPCS code C9763 describes a specific procedure known as cardiac magnetic resonance imaging for morphology and function, with quantification of segmental dysfunction, including stress imaging. This code is used to identify and bill for the performance of this particular diagnostic test, which is used to evaluate the structure and function of the heart.

1. What is HCPCS C9763?

HCPCS code C9763 is a specific alphanumeric code that is part of the Healthcare Common Procedure Coding System (HCPCS). It is used to identify and bill for the performance of cardiac magnetic resonance imaging for morphology and function, with quantification of segmental dysfunction, including stress imaging.

2. Official Description

The official description of HCPCS code C9763 is “Cardiac magnetic resonance imaging for morphology and function, quantification of segmental dysfunction; with stress imaging.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The provider begins by preparing the patient for the cardiac magnetic resonance imaging (MRI) procedure.
2. The patient is positioned on the MRI table, and the necessary equipment and devices are set up.
3. The provider then administers a contrast agent, if required, to enhance the visibility of the heart structures during the imaging process.
4. The MRI machine is used to capture detailed images of the heart, including its morphology and function.
5. If stress imaging is indicated, the patient may be subjected to additional procedures or exercises to induce stress on the heart.
6. Throughout the procedure, the provider closely monitors the patient’s vital signs and ensures their comfort and safety.
7. Once the imaging is complete, the provider reviews and analyzes the obtained images to assess any segmental dysfunction or abnormalities.
8. A detailed report is generated, documenting the findings and interpretations of the cardiac MRI.

4. When to use HCPCS code C9763

HCPCS code C9763 should be used when performing cardiac magnetic resonance imaging for the evaluation of morphology and function, with quantification of segmental dysfunction, including stress imaging. This code is specifically designed for this particular diagnostic test and should not be used for other procedures or services.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9763, healthcare providers need to ensure that the necessary documentation is in place to support the medical necessity and appropriateness of the procedure. This may include the patient’s medical history, relevant clinical notes, and any other supporting documentation. Additionally, providers should follow the specific billing guidelines and requirements set forth by the payer, such as Medicare or other insurance carriers.

6. Historical Information and Code Maintenance

HCPCS code C9763 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996, and 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

HCPCS code C9763 may be eligible for coverage 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 guidance on coverage and reimbursement for this procedure.

8. Examples

Here are five examples of scenarios where HCPCS code C9763 may be billed:

1. A patient with known cardiac abnormalities undergoes cardiac MRI for the evaluation of segmental dysfunction and stress imaging.
2. A patient with suspected heart disease undergoes cardiac MRI to assess the morphology and function of the heart.
3. A patient with a history of heart failure undergoes cardiac MRI to monitor the progression of the disease and evaluate any segmental dysfunction.
4. A patient with chest pain and abnormal stress test results undergoes cardiac MRI for further evaluation and quantification of segmental dysfunction.
5. A patient with a recent heart attack undergoes cardiac MRI to assess the extent of damage and segmental dysfunction in the affected area.