How To Use HCPCS Code C9789

HCPCS code C9789 describes the instillation of an anti-neoplastic pharmacologic/biologic agent into the renal pelvis, using any method, including all imaging guidance and volumetric measurement if performed. This code is used to identify a specific procedure that involves the administration of a medication directly into the renal pelvis, which is the area of the kidney where urine collects before it is passed into the ureter.

1. What is HCPCS C9789?

HCPCS code C9789 is a specific code that is used to identify the instillation of an anti-neoplastic pharmacologic/biologic agent into the renal pelvis. This procedure involves the administration of a medication directly into the renal pelvis, which is the area of the kidney where urine collects before it is passed into the ureter. The purpose of this procedure is to deliver the medication directly to the affected area in order to treat or manage a neoplastic condition, which refers to the abnormal growth of cells that can be cancerous.

2. Official Description

The official description of HCPCS code C9789 is “Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure of HCPCS code C9789 involves the instillation of an anti-neoplastic pharmacologic/biologic agent into the renal pelvis.
2. The medication is administered using any method that is deemed appropriate for the patient’s condition and the healthcare provider’s preference.
3. All imaging guidance is utilized during the procedure to ensure accurate placement of the medication into the renal pelvis.
4. If necessary, volumetric measurement may be performed to determine the appropriate dosage of the medication.

4. When to use HCPCS code C9789

HCPCS code C9789 should be used when a healthcare provider performs the instillation of an anti-neoplastic pharmacologic/biologic agent into the renal pelvis. This procedure is typically performed to treat or manage a neoplastic condition in the kidney. It is important to note that this code should only be used when the procedure specifically involves the renal pelvis and not other areas of the kidney.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9789, healthcare providers should ensure that the necessary documentation is included to support the medical necessity of the procedure. This may include the patient’s medical history, diagnostic test results, and any other relevant information. Additionally, providers should follow the appropriate billing guidelines set forth by Medicare or other insurance carriers to ensure accurate and timely reimbursement for the service.

6. Historical Information and Code Maintenance

HCPCS code C9789 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions to the code since its addition.

7. Medicare and Insurance Coverage

HCPCS code C9789 is covered by Medicare. 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. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130, 4450 for additional information on coverage and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C9789 should be billed:

1. A patient with a diagnosed neoplastic condition in the renal pelvis undergoes an instillation of an anti-neoplastic medication into the renal pelvis.
2. A healthcare provider performs an imaging-guided instillation of an anti-neoplastic pharmacologic/biologic agent into the renal pelvis for a patient with a confirmed neoplastic condition.
3. A patient with a history of neoplastic conditions in the renal pelvis receives an instillation of an anti-neoplastic medication into the renal pelvis as part of their ongoing treatment plan.
4. A healthcare provider administers an anti-neoplastic pharmacologic/biologic agent into the renal pelvis using volumetric measurement to ensure accurate dosage for a patient with a neoplastic condition.
5. A patient with a neoplastic condition in the renal pelvis undergoes an instillation of an anti-neoplastic medication into the renal pelvis as a palliative treatment option.