Question 1

What is HCPCS code C9468?

Accepted Answer

HCPCS code C9468 is "Inj, factor ix, rebinyn". Injection, factor ix (antihemophilic factor, recombinant), glycopegylated, rebinyn, 1 i.u.

Question 2

What category is C9468 in?

Accepted Answer

C9468 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9468?

Accepted Answer

Use C9468 when billing for inj, factor ix, rebinyn. 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 C9468 covered by Medicare?

Accepted Answer

Coverage for C9468 (Inj, factor ix, rebinyn) 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 C9468?

Accepted Answer

Documentation for C9468 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).