How To Use HCPCS Code C9790

HCPCS code C9790 describes the procedure of histotripsy, a non-thermal ablation technique that uses acoustic energy to destroy malignant renal tissue. This code is used when performing histotripsy with image guidance. In this article, we will explore the details of HCPCS code C9790, including its official description, procedure, usage guidelines, billing requirements, historical information, and Medicare coverage.

1. What is HCPCS C9790?

HCPCS code C9790 is a specific code used to identify the procedure of histotripsy for the non-thermal ablation of malignant renal tissue. It includes the use of acoustic energy delivery and image guidance. This code is essential for accurate medical coding and billing purposes, ensuring proper reimbursement for the healthcare provider.

2. Official Description

The official description of HCPCS code C9790 is “Histotripsy (i.e., non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance.” The short description for this code is “Enteral supp not otherwise c.” It is crucial to use the exact official description when assigning this code to ensure accurate representation of the procedure performed.

3. Procedure

1. The histotripsy procedure begins with the patient being positioned appropriately for the treatment of malignant renal tissue.
2. The healthcare provider uses image guidance, such as ultrasound or other imaging modalities, to visualize the target area.
3. Acoustic energy is then delivered to the malignant renal tissue using specialized equipment.
4. The non-thermal ablation process of histotripsy breaks down the tissue without the use of heat, effectively destroying the malignant cells.
5. Throughout the procedure, the healthcare provider monitors the progress and adjusts the treatment as necessary.
6. Once the histotripsy procedure is complete, the patient may require post-procedure care and monitoring.

4. When to use HCPCS code C9790

HCPCS code C9790 should be used when performing histotripsy for the non-thermal ablation of malignant renal tissue. It is important to note that this code is specific to cases involving image guidance. Healthcare providers should ensure that the procedure meets the criteria outlined in the official description before assigning this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9790, healthcare providers must accurately document the details of the histotripsy procedure, including the use of image guidance and the specific location of the malignant renal tissue. Proper documentation is crucial for supporting the medical necessity of the procedure and ensuring appropriate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9790 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 since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code C9790 falls under the special coverage instructions category, denoted by the coverage code D. This indicates that specific coverage guidelines may apply when billing for this procedure. Healthcare providers should consult the Medicare Carriers Manual Reference Section Number 2130 for further information on coverage and reimbursement.

8. Examples

Here are five examples of scenarios where HCPCS code C9790 should be billed:

1. A patient with a confirmed diagnosis of malignant renal tissue undergoes histotripsy with image guidance for non-thermal ablation.
2. A healthcare provider performs histotripsy on a patient with a history of renal cancer, targeting a specific area of malignant tissue.
3. A patient with renal cell carcinoma undergoes histotripsy as part of their treatment plan, guided by real-time imaging.
4. A healthcare provider performs histotripsy on a patient with a large renal tumor, utilizing image guidance to ensure precise targeting of the malignant tissue.
5. A patient with metastatic renal cancer undergoes histotripsy for the ablation of malignant tissue in the kidneys, with the assistance of image guidance.