Question 1

What is HCPCS code C8926?

Accepted Answer

HCPCS code C8926 is "Tee w or w/o fol w/cont,cong". Transesophageal echocardiography (tee) with contrast, or without contrast followed by with contrast, for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report

Question 2

What category is C8926 in?

Accepted Answer

C8926 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C8926?

Accepted Answer

Use C8926 when billing for tee w or w/o fol w/cont,cong. 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

What ICD-10 codes are commonly used with C8926?

Accepted Answer

Common ICD-10 diagnosis codes used with C8926 include: A02.1 (Salmonella sepsis), A18.84 (Tuberculosis of heart), A22.7 (Anthrax sepsis), A26.7 (Erysipelothrix sepsis). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is C8926 covered by Medicare?

Accepted Answer

Coverage for C8926 (Tee w or w/o fol w/cont,cong) 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 6

What documentation is required for C8926?

Accepted Answer

Documentation for C8926 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).