C9790 HCPCS - HISTOTRIPSY (IE, NON-THERMAL ABLATION VIA ACOUSTIC ENERGY DELIVERY) OF MALIGNANT RENAL TISSUE, INCLUDING IMAGE GUIDANCE

Code Information

  • HCPCS Code: C9790
  • Sequence Number: 0010
  • Short Description: Kidney histotripsy w/image
  • Long Description: Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance
  • Date Added: 10/1/2023
  • Action Code: D - Discontinue procedure or modifier code
  • Action Effective Date: 7/1/2024
  • Classification: Temporary Hospital Outpatient Prospective Payment System
  • Coding System: HCPCS

Code Type

  • Berenson-Eggers Type Of Service Code: P1G - Major procedure - Other
  • Type Of Service Code:
    • 6 - Therapeutic radiology
    • F - Ambulatory surgical center (facility usage for surgical services)

Billing Information

  • Pricing Indicator Code:
    • 53 - Statute
  • Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
  • Coverage Issues Manual Reference Section Number:
      N/A
    • Medicare Carriers Manual Reference Section Number:
        N/A
      • Coverage Code: D - Special coverage instructions apply

      HCPCS Record

      Field Name Field Value
      Healthcare Common Procedure Coding System Code C9790
      HCPCS Sequence Number 0010
      HCPCS Record Identification Code 3 - First line of procedure record also contains detail information in positions 92-275
      HCPCS Long Description Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including image guidance
      HCPCS Short Description Kidney histotripsy w/image
      HCPCS Pricing Indicator Code 1 53 - Statute
      HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
      HCPCS Statute Number 1833(t)
      HCPCS Cross Reference Code 1 0888T
      HCPCS Coverage Code D - Special coverage instructions apply
      HCPCS Berenson-Eggers Type Of Service Code P1G - Major procedure - Other
      HCPCS Type Of Service Code 1 6 - Therapeutic radiology
      HCPCS Type Of Service Code 2 F - Ambulatory surgical center (facility usage for surgical services)
      HCPCS Anesthesia Base Unit Quantity 0
      HCPCS Code Added Date 10/1/2023
      HCPCS Action Effective Date 7/1/2024
      HCPCS Termination Date 6/30/2024
      HCPCS Action Code D - Discontinue procedure or modifier code

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      This page was last updated on: 7/1/2024