How To Use HCPCS Code C9778

HCPCS code C9778 describes a specific procedure known as colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous). This code is used to identify a surgical technique used to treat pelvic organ prolapse in women. In this article, we will explore the details of HCPCS code C9778, including its official description, procedure, when to use it, billing guidelines, historical information, and Medicare and insurance coverage.

1. What is HCPCS C9778?

HCPCS code C9778 is a specific code used to identify the procedure of colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous). This procedure involves the surgical repair of pelvic organ prolapse, which occurs when the muscles and tissues that support the pelvic organs become weak or damaged. The minimally invasive extra-peritoneal approach, specifically the sacrospinous technique, is used to provide support to the vaginal vault and restore normal anatomical positioning.

2. Official Description

The official description of HCPCS code C9778 is “Colpopexy, vaginal; minimally invasive extra-peritoneal approach (sacrospinous).” The short description for this code is “Enteral supp not otherwise c.” This description accurately represents the specific procedure being performed.

3. Procedure

1. The provider begins by making a small incision in the vaginal wall.
2. A tunnel is then created through the vaginal wall and extended to the sacrospinous ligament.
3. The provider attaches a synthetic mesh or graft material to the sacrospinous ligament, providing support to the vaginal vault.
4. The mesh or graft material is then secured to the vaginal wall, ensuring proper positioning and support.
5. The incision in the vaginal wall is closed, completing the procedure.

4. When to use HCPCS code C9778

HCPCS code C9778 should be used when performing a colpopexy procedure using the minimally invasive extra-peritoneal approach with the sacrospinous technique. This code is specifically intended for cases where the provider is addressing pelvic organ prolapse in a vaginal setting. It is important to ensure that the procedure meets the criteria outlined in the official description to accurately use this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9778, healthcare providers should ensure that the necessary documentation is in place to support the procedure performed. This may include operative reports, documentation of the patient’s condition and symptoms, and any pre-authorization or medical necessity requirements. It is important to follow the specific billing guidelines set forth by Medicare or other insurance carriers to ensure proper reimbursement for the procedure.

6. Historical Information and Code Maintenance

HCPCS code C9778 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, 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 remained unchanged since its inception, indicating its stability and relevance in the medical coding and billing field.

7. Medicare and Insurance Coverage

HCPCS code C9778 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 C9778 should be billed:

1. A 55-year-old female patient presents with symptomatic pelvic organ prolapse. The provider performs a colpopexy using the minimally invasive extra-peritoneal approach with the sacrospinous technique.
2. A 60-year-old female patient with a history of pelvic organ prolapse undergoes a colpopexy procedure using the minimally invasive extra-peritoneal approach with the sacrospinous technique to address recurrent prolapse.
3. A 45-year-old female patient with severe pelvic organ prolapse undergoes a colpopexy procedure using the minimally invasive extra-peritoneal approach with the sacrospinous technique to restore normal anatomical positioning.
4. A 50-year-old female patient presents with symptomatic vaginal vault prolapse. The provider performs a colpopexy using the minimally invasive extra-peritoneal approach with the sacrospinous technique to provide support to the vaginal vault.
5. A 65-year-old female patient with a history of pelvic organ prolapse undergoes a colpopexy procedure using the minimally invasive extra-peritoneal approach with the sacrospinous technique to address recurrent prolapse and improve quality of life.