How To Use HCPCS Code C9768

HCPCS code C9768 describes the endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method. This code is used to identify a specific procedure that involves the measurement of the pressure gradient between the hepatic portal vein and the systemic circulation. It is an important diagnostic tool used in the evaluation and management of certain liver diseases and conditions.

1. What is HCPCS C9768?

HCPCS code C9768 is a specific code that is used to identify the endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method. This procedure involves the use of endoscopic ultrasound to directly measure the pressure gradient between the hepatic portal vein and the systemic circulation. It is an important diagnostic tool used in the evaluation and management of certain liver diseases and conditions.

2. Official Description

The official description of HCPCS code C9768 is “Endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method (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 provider begins by preparing the patient for the procedure, which may include fasting or other specific instructions.
2. An endoscope is inserted into the patient’s gastrointestinal tract through the mouth or anus.
3. The endoscope is guided to the area of interest, which is the hepatic portal vein.
4. An ultrasound probe is attached to the endoscope, allowing the provider to visualize the hepatic portal vein and surrounding structures.
5. The provider then measures the pressure gradient between the hepatic portal vein and the systemic circulation using a specialized device or method.
6. The measurement is recorded and documented for further analysis and interpretation.
7. The endoscope is carefully removed from the patient’s gastrointestinal tract.

4. When to use HCPCS code C9768

HCPCS code C9768 should be used when the provider performs the endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient by any method. This procedure is typically performed in the evaluation and management of liver diseases and conditions, such as portal hypertension or liver cirrhosis. It is important to note that this code should be used in addition to the primary procedure code, as it represents a separate and distinct service.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9768, healthcare providers should ensure that the documentation supports the performance of the endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient. This may include the procedure notes, measurement results, and any other relevant documentation. It is also important to follow the specific billing guidelines and requirements of the payer, as well as any applicable coding and documentation guidelines.

6. Historical Information and Code Maintenance

HCPCS code C9768 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 is classified under the type of service code E, which represents enteral/parenteral nutrients/supplies.

7. Medicare and Insurance Coverage

HCPCS code C9768 is subject to specific coverage instructions, as indicated by the coverage code D. This means that special coverage instructions apply to this code, and healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for further guidance. 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 that it is not applicable as HCPCS priced under one methodology.

8. Examples

Here are five examples of when HCPCS code C9768 should be billed:

1. A patient with liver cirrhosis undergoes an endoscopic ultrasound-guided direct measurement of hepatic portosystemic pressure gradient to assess the severity of portal hypertension.
2. A patient with suspected portal vein thrombosis undergoes the procedure to confirm the diagnosis and determine the extent of the thrombus.
3. A patient with a history of liver disease undergoes regular monitoring of the hepatic portosystemic pressure gradient to assess the effectiveness of treatment.
4. A patient with suspected hepatic veno-occlusive disease undergoes the procedure to evaluate the patency of the hepatic veins and assess the severity of the disease.
5. A patient with suspected hepatocellular carcinoma undergoes the procedure to assess the risk of portal vein invasion and plan appropriate treatment.