Question 1

What is HCPCS code C7504?

Accepted Answer

HCPCS code C7504 is "Perq cvt&ls inj vert bodies". Percutaneous vertebroplasties (bone biopsies included when performed), first cervicothoracic and any additional cervicothoracic or lumbosacral vertebral bodies, unilateral or bilateral injection, inclusive of all imaging guidance

Question 2

What category is C7504 in?

Accepted Answer

C7504 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C7504?

Accepted Answer

Use C7504 when billing for perq cvt&ls inj vert bodies. 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 C7504 covered by Medicare?

Accepted Answer

Coverage for C7504 (Perq cvt&ls inj vert bodies) 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 C7504?

Accepted Answer

Documentation for C7504 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).