Question 1

What is HCPCS code C9048?

Accepted Answer

HCPCS code C9048 is "Dexamethasone ophth insert". Dexamethasone, lacrimal ophthalmic insert, 0.1 mg

Question 2

What category is C9048 in?

Accepted Answer

C9048 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9048?

Accepted Answer

Use C9048 when billing for dexamethasone ophth insert. 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 C9048 covered by Medicare?

Accepted Answer

Coverage for C9048 (Dexamethasone ophth insert) 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 C9048?

Accepted Answer

Documentation for C9048 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).