Wiki C9733 - Billiable for stand alone Clinic

[ccosta]

Looking for advice on HCPCS code C9733. Work for insurance company, and from what i have gathered, this is a bundlec code for ASC and Outpatient hospital billing. Provider states they can bill for this since they have a "Q" status instead of a "T" status.
Can someone assist in determining if provider in separate clinic can bill for this service for wound care. I have searched CMS and material all states it is bundled. This was done in 2012, in regards to making it a bundled service.
Any information would be helpful.
Thanks,
Carl Costa

 

[rlh27]

This is from the Federal Register Vol. 78 No. 237

We created HCPCS code C9733 (Nonophthalmic fluorescent vascular angiography (FVA)), effective April 1, 2012, for a service that became known to us through the new technology APC application process. We assigned HCPCS code C9733 to APC 0397 (Vascular Imaging), which had a CY 2012 payment rate of $154.87 and a status indicator of ??Q2.?? The ??Q2??status indicator shows that payment for the service will be packaged in the APC payment if billed on the same date of service as a HCPCS code assigned status indicator ??T??; and in all other circumstances, a separate APC payment for the service will be made. We maintained the assignment of HCPCS code C9733 to APC 0397 for CY 2013, which has a payment rate of $330.97, and continued the assignment of status indicator ??Q2.??

 

[ccosta]

Thanks for your help, it was a tricky situation but i think we have convinced the provider that not every time is the company Rep correct in what they state regarding billing.
carl