How To Use HCPCS Code C9791

HCPCS code C9791 describes the procedure of magnetic resonance imaging (MRI) with inhaled hyperpolarized xenon-129 contrast agent for the chest. This code includes the preparation and administration of the contrast agent. In this article, we will explore the details of HCPCS code C9791, including its official description, procedure, when to use it, billing guidelines, historical information, Medicare and insurance coverage, and provide examples of when this code should be billed.

1. What is HCPCS C9791?

HCPCS code C9791 is used to identify the specific procedure of magnetic resonance imaging (MRI) with inhaled hyperpolarized xenon-129 contrast agent for the chest. This code is used when performing an MRI scan of the chest using a specialized contrast agent called hyperpolarized xenon-129. The code also includes the preparation and administration of the contrast agent.

2. Official Description

The official description of HCPCS code C9791 is “Magnetic resonance imaging with inhaled hyperpolarized xenon-129 contrast agent, chest, including preparation and administration of agent.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The procedure of HCPCS code C9791 involves the use of magnetic resonance imaging (MRI) technology to obtain detailed images of the chest.
2. Prior to the MRI scan, the patient is prepared for the procedure, which may include changing into a hospital gown and removing any metallic objects or jewelry.
3. The patient is positioned on the MRI table, and a specialized coil is placed around the chest area to enhance image quality.
4. The contrast agent, in this case, the inhaled hyperpolarized xenon-129, is administered to the patient.
5. The patient is then moved into the MRI machine, which uses a strong magnetic field and radio waves to capture detailed images of the chest.
6. The MRI technologist operates the machine from a separate control room and communicates with the patient through an intercom system.
7. During the scan, the patient is required to remain still to ensure clear and accurate images.
8. Once the scan is complete, the patient can resume normal activities.

4. When to use HCPCS code C9791

HCPCS code C9791 should be used when performing a magnetic resonance imaging (MRI) scan of the chest using inhaled hyperpolarized xenon-129 contrast agent. This code is specific to the chest area and should not be used for MRI scans of other body parts or for different contrast agents.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9791, healthcare providers need to document the use of inhaled hyperpolarized xenon-129 contrast agent for the chest MRI. This documentation should include the medical necessity for using this specific contrast agent and any relevant patient information. Providers should also ensure that the procedure is coded accurately and submitted with the appropriate supporting documentation.

6. Historical Information and Code Maintenance

HCPCS code C9791 was added to the Healthcare Common Procedure Coding System on January 01, 1985. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. The code has a pricing indicator code of 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.

7. Medicare and Insurance Coverage

Medicare and insurance coverage for HCPCS code C9791 may vary. Providers should check with the specific payer to determine coverage and reimbursement policies for this procedure. The Medicare Carriers Manual Reference Section Number for this code is 2130, which provides additional guidance on coverage and billing for this procedure.

8. Examples

Here are five examples of when HCPCS code C9791 should be billed:

1. A patient with suspected lung cancer undergoes a chest MRI with inhaled hyperpolarized xenon-129 contrast agent to assess the extent of the disease.
2. A patient with a history of pulmonary fibrosis undergoes a chest MRI with inhaled hyperpolarized xenon-129 contrast agent to monitor disease progression.
3. A patient with a suspected pulmonary embolism undergoes a chest MRI with inhaled hyperpolarized xenon-129 contrast agent to rule out the presence of a blood clot.
4. A patient with a known chest wall tumor undergoes a chest MRI with inhaled hyperpolarized xenon-129 contrast agent to evaluate tumor size and characteristics.
5. A patient with a chronic lung disease undergoes a chest MRI with inhaled hyperpolarized xenon-129 contrast agent as part of a research study to assess lung function.