C9122

Notice

• HCPCS C9122 terminated on March 31, 2021.

Short Description

• Mometasone furoate (sinuva)

HCPCS Coverage Code

• D = Special coverage instructions apply

HCPCS Action Code

• N = No maintenance for this code

HCPCS Action Effective Date

• April 01, 2021

HCPCS Code Added Date

• July 01, 2020

HCPCS Termination Date

• March 31, 2021

HCPCS Pricing Indicator Code

• 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

• J7402

HCPCS Type Of Service Code

• 9 = Other medical items or servicesF = Ambulatory surgical center (facility usage for surgical services)

HCPCS Anesthesia Base Unit Quantity

• 0