Question 1

What is HCPCS code C9738?

Accepted Answer

HCPCS code C9738 is "Blue light cysto imag agent". Adjunctive blue light cystoscopy with fluorescent imaging agent  (list separately in addition to code for primary procedure)

Question 2

What category is C9738 in?

Accepted Answer

C9738 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9738?

Accepted Answer

Use C9738 when billing for blue light cysto imag agent. 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 C9738 covered by Medicare?

Accepted Answer

Coverage for C9738 (Blue light cysto imag agent) 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 C9738?

Accepted Answer

Documentation for C9738 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).