Question 1

What is HCPCS code C9789?

Accepted Answer

HCPCS code C9789 is "Instill pharm renal pelvis". Instillation of anti-neoplastic pharmacologic/biologic agent into renal pelvis, any method, including all imaging guidance, including volumetric measurement if performed

Question 2

What category is C9789 in?

Accepted Answer

C9789 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9789?

Accepted Answer

Use C9789 when billing for instill pharm renal pelvis. 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 C9789 covered by Medicare?

Accepted Answer

Coverage for C9789 (Instill pharm renal pelvis) 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 C9789?

Accepted Answer

Documentation for C9789 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).