Question 1

What is HCPCS code C9098?

Accepted Answer

HCPCS code C9098 is "Ciltacabtagene car pos t". Ciltacabtagene autoleucel, up to 100 million autologous b-cell maturation antigen (bcma) directed car-positive t cells, including leukapheresis and dose preparation procedures, per therapeutic dose

Question 2

What category is C9098 in?

Accepted Answer

C9098 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9098?

Accepted Answer

Use C9098 when billing for ciltacabtagene car pos t. 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 C9098 covered by Medicare?

Accepted Answer

Coverage for C9098 (Ciltacabtagene car pos t) 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 C9098?

Accepted Answer

Documentation for C9098 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).