Question 1

What is HCPCS code C9899?

Accepted Answer

HCPCS code C9899 is "Inpt implant pros dev,no cov". Implanted prosthetic device, payable only for inpatients who do not have inpatient coverage

Question 2

What category is C9899 in?

Accepted Answer

C9899 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9899?

Accepted Answer

Use C9899 when billing for inpt implant pros dev,no cov. 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 C9899 covered by Medicare?

Accepted Answer

Coverage for C9899 (Inpt implant pros dev,no cov) 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 C9899?

Accepted Answer

Documentation for C9899 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).