HCPCS code C9738 — Blue light cysto imag agent.
Status: Active.
Effective Jan 1, 2018.
Source: CMS HCPCS Level II.
C9738
ActiveBlue light cysto imag agent
Adjunctive blue light cystoscopy with fluorescent imaging agent (list separately in addition to code for primary procedure)
Category:
Outpatient PPS
Section:
C-codes: Outpatient PPS
Effective:
Jan 1, 2018
Code type:
alphanumeric
OPPS Status:
N
— Items / services packaged into APC rates
MUE — Medically Unlikely Edits
Maximum units of C9738 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NCCI Edits
The following codes cannot be billed together with C9738 without appropriate documentation.
| Column 2 Code | Modifier |
|---|---|
| G0463 | Modifier may bypass edit |
| G0471 | Modifier cannot bypass edit |
| P9612 | Modifier cannot bypass edit |
Source: CMS National Correct Coding Initiative (NCCI)