Summary & Overview
HCPCS C1052: Hemostatic Agent, Gastrointestinal, Topical
HCPCS Level II code C1052 denotes a topical hemostatic agent for gastrointestinal use. These products are applied directly to bleeding sites in the GI tract during endoscopic or surgical procedures to achieve hemostasis. Nationally, use of topical gastrointestinal hemostats matters for procedural safety, device supply management, and procedure-level cost considerations across hospitals and ambulatory endoscopy centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for topical GI hemostats, typical sites of service, and the payer landscape addressed. The publication summarizes benchmark considerations for coverage and coding of C1052, highlights relevant clinical scenarios where topical hemostats are used, and outlines common documentation elements that payers review.
The content provides a practical reference for health system billing staff, revenue cycle leaders, and clinical procurement teams seeking clear definitions and payer scope. Data elements not provided in the input are noted as unavailable; the focus remains on accurate description of the code, clinical service setting, and the payers typically involved in adjudicating claims for topical gastrointestinal hemostatic agents.
Billing Code Overview
HCPCS Level II code C1052 describes a hemostatic agent, gastrointestinal, topical. This code represents a topical product applied to gastrointestinal mucosa to control bleeding during endoscopic or surgical procedures.
Service type: Topical hemostatic agent for gastrointestinal procedures
Typical site of service: Endoscopy suite or operating room
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient undergoing upper endoscopy (esophagogastroduodenoscopy) for melena and symptomatic iron-deficiency anemia is found to have an actively bleeding gastric ulcer. After standard endoscopic hemostatic techniques (injection and/or thermal coagulation) there is persistent oozing from the ulcer base. A topical gastrointestinal hemostatic agent is applied endoscopically to the bleeding site to achieve clot formation and cessation of bleeding. The service is provided in an ambulatory endoscopy suite or hospital endoscopy unit under moderate sedation with monitoring by the gastroenterology team. Documentation includes indication for hemostasis, endoscopic findings, agent name and amount, technique of application, immediate hemostatic result, and any complications. Typical workflow: pre-procedure consent and diagnosis coding, performance of diagnostic and therapeutic endoscopy, application of topical hemostatic agent C1052 when indicated, post-procedure recovery and discharge or admission if required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the work required to apply C1052 involves substantially greater effort or time than typical and documentation supports increased complexity. |