How To Use HCPCS Code C9793

HCPCS code C9793 describes the use of a 3D predictive model generation for pre-planning of a cardiac procedure. This code is specifically used when data from cardiac computed tomographic angiography is utilized, along with a detailed report. In this article, we will explore the various aspects of HCPCS code C9793, including its official description, procedure, when to use it, billing guidelines and documentation requirements, historical information and code maintenance, Medicare and insurance coverage, as well as provide examples of when this code should be billed.

1. What is HCPCS C9793?

HCPCS code C9793 is a specific code used to identify the utilization of a 3D predictive model generation for pre-planning of a cardiac procedure. This code is applicable when data from cardiac computed tomographic angiography is used, along with a detailed report. It is important to note that this code is specific to the described procedure and should not be used for any other purpose.

2. Official Description

The official description of HCPCS code C9793 is “3D predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography with report.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins by obtaining the necessary data from a cardiac computed tomographic angiography.
2. Using this data, a 3D predictive model is generated to aid in the pre-planning of a cardiac procedure.
3. The provider then prepares a detailed report based on the findings of the 3D predictive model.
4. This report is used to guide the subsequent cardiac procedure, ensuring optimal planning and outcomes.

4. When to use HCPCS code C9793

HCPCS code C9793 should be used when a healthcare provider utilizes a 3D predictive model generated from data obtained through cardiac computed tomographic angiography for the purpose of pre-planning a cardiac procedure. It is important to ensure that all the necessary criteria are met before using this code, as it is specific to this particular procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9793, healthcare providers need to ensure that they have documented the utilization of a 3D predictive model generated from cardiac computed tomographic angiography data. This documentation should include details of the procedure, the report generated, and any other relevant information. It is important to follow the specific billing guidelines set forth by the payer to ensure accurate reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9793 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 system.

7. Medicare and Insurance Coverage

HCPCS code C9793 is subject to special coverage instructions, as indicated by the coverage code D. This means that specific guidelines and criteria may apply when seeking reimbursement for this procedure. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. It is important to check with Medicare and other insurance providers to determine coverage and reimbursement details for this specific code.

8. Examples

Here are five examples of scenarios in which HCPCS code C9793 should be billed:

1. A patient undergoes a cardiac computed tomographic angiography, and based on the findings, a 3D predictive model is generated for pre-planning a cardiac procedure.
2. A healthcare provider utilizes data from a cardiac computed tomographic angiography to create a 3D predictive model, which is then used to guide the pre-planning of a cardiac procedure.
3. Following a cardiac computed tomographic angiography, a detailed report is generated based on the 3D predictive model, aiding in the pre-planning of a cardiac procedure.
4. A patient with a cardiac condition undergoes a cardiac computed tomographic angiography, and the resulting data is used to generate a 3D predictive model for pre-planning a cardiac procedure.
5. A healthcare provider utilizes a 3D predictive model generated from data obtained through cardiac computed tomographic angiography to guide the pre-planning of a cardiac procedure for a patient.