Outpatient Coders: Are These C Codes on Your Procedure Reporting List?

2019 HCPCS codes for outpatient reporting

The HCPCS 2019 code set features several new C codes related to reporting procedures. If you use C codes, make sure you’ve got these updates on your radar.

Reminder: HCPCS C codes are intended for use by Outpatient Prospective Payment System (OPPS) hospitals. The codes are used to report device categories, new technology procedures, and also drugs, biologicals, and radiopharmaceuticals that don’t have other specific HCPCS codes that apply to them. Other facilities may use C codes at their discretion, specifically non-OPPS hospitals; Critical Access Hospitals; Indian Health Service Hospitals; hospitals in American Samoa, Guam, Saipan, and the Virgin Islands; and Maryland waiver hospitals.

Watch for the C Codes That Apply to Your Claims

Neurostimulator generator: The first new C code applies to a non-rechargeable neurostimulator generator, C1823 (Generator, neurostimulator (implantable), non-rechargeable, with transvenous sensing and stimulation leads).

MRI CAD: If you use C codes for breast MRI CAD, don’t miss new code C8937 (Computer-aided detection, including computer algorithm analysis of breast MRI image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)).

Note that this code is an add-on code, so be sure you report the MRI using a primary code.

Nasal repair: There’s also a C code for nasal repair, C9749 (Repair of nasal vestibular lateral wall stenosis with implant(s)).

This code will be new in your manual for 2019 if you use paper manuals, but the code has been effective since April 2018. According to the 2019 OPPS and ASC Final Rule, this code describes the Latera absorbable implant procedure for nasal airway obstruction.

Bronchoscopy: Note the inclusion of microwave ablation in C9751 (Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including  fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, image-guided navigation, and endobronchial ultrasound (ebus) guided transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s)).

According to the OPPS Final Rule, this procedure uses a flexible catheter to access the lung tumor via a working channel. It is an alternative to a percutaneous microwave approach.

Nerve destruction: There are two new codes for intraosseous basivertebral nerve destruction. Use C9752 for the first two vertebral bodies and C9753 for each additional vertebral body. Consider these codes for the Relievant Intracept Procedure:

  • C9752 (Destruction of intraosseous basivertebral nerve, first two vertebral bodies, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum)
  • C9753 (Destruction of intraosseous basivertebral nerve, each additional vertebral body, including imaging guidance (e.g., fluoroscopy), lumbar/sacrum (list separately in addition to code for primary procedure)).

AV fistula creation: There are also two new codes for percutaneous arteriovenous fistula creation using newer technology:

  • C9754 (Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed))
  • C9755 (Creation of arteriovenous fistula, percutaneous using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed).

What About You?

Do you report C codes? Do you find them useful, or do you wish Medicare would use only non-C codes so everyone used the same codes?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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