Oncology & Hematology Coding Alert

Question: Has the code C9743, for spacers, been deleted? How can we now bill for spacers?

Florida Subscriber

Answer: The code C9743 (Injection/implantation of bulking or spacer material [any type] with or without imaging guidance [not to be used if a more specific code applies]) was deleted effective June 30, 2016. You now have a new category III CPT^® code 0438T (Transperineal placement of biodegradable material, peri-prostatic [via needle], single or multiple, includes image guidance). However, you should check with your payers for reimbursement of this Category III temporary procedure code.

Note: Hospitals submit code 0438T for technical service and physicians submit it for professional services.

For more on the new codes, you may refer to the MLN Matters MM9658 (Transmittal 3523) at: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9658.pdf.