Question 1

What is HCPCS code C1734?

Accepted Answer

HCPCS code C1734 is "Orth/devic/drug bn/bn,tis/bn". Orthopedic/device/drug matrix for opposing bone-to-bone or soft tissue-to bone (implantable)

Question 2

What category is C1734 in?

Accepted Answer

C1734 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C1734?

Accepted Answer

Use C1734 when billing for orth/devic/drug bn/bn,tis/bn. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is C1734 covered by Medicare?

Accepted Answer

Coverage for C1734 (Orth/devic/drug bn/bn,tis/bn) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for C1734?

Accepted Answer

Documentation for C1734 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).