Question 1

What is HCPCS code C8004?

Accepted Answer

HCPCS code C8004 is "Sim ang w/prs cath rad emb". Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the angiogram, for subsequent therapeutic radioembolization of tumors

Question 2

What category is C8004 in?

Accepted Answer

C8004 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C8004?

Accepted Answer

Use C8004 when billing for sim ang w/prs cath rad emb. 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 C8004 covered by Medicare?

Accepted Answer

Coverage for C8004 (Sim ang w/prs cath rad emb) 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 C8004?

Accepted Answer

Documentation for C8004 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).