Summary & Overview
HCPCS C1602: Absorbable Antimicrobial-Eluting Bone Void Filler, Implantable
HCPCS Level II code C1602 identifies an implantable, absorbable bone void filler that elutes antimicrobial agents. This device is used in orthopedic procedures to fill bone defects while delivering local antimicrobial therapy, which can be clinically significant for reducing postoperative infection risk and supporting bone healing. Nationally, coding clarity for implantable combination products like this affects device billing, hospital charge capture, and payer coverage determinations.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical use and site-of-service implications, typical payer considerations, and what to expect in coverage and claims processing for this HCPCS Level II code. The publication summarizes benchmarks where available, outlines relevant policy and reimbursement themes, and provides clinical context for when an antimicrobial-eluting absorbable bone void filler is utilized. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1602 describes an implantable absorbable bone void filler that elutes antimicrobial agents. The item combines an orthopedic device and drug matrix designed to fill bone voids while providing local antimicrobial release to reduce infection risk.
Service Type: Implantable orthopedic bone void filler with antimicrobial elution
Typical Site of Service: Inpatient or outpatient surgical settings, including operating rooms and procedure suites where orthopedic implantable devices are placed
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult undergoing surgical management of a contaminated or infected orthopedic defect or a traumatic bone void where local antimicrobial delivery and osteoconductive, absorbable void filling is required. Common scenarios include open tibial fracture with bone loss and contamination, revision arthroplasty with peri-prosthetic infection requiring debridement and local antimicrobial implantation, or cavitary bone defects after tumor curettage. The clinical workflow: preoperative evaluation confirms indication with imaging and cultures; informed consent documents use of an implantable, absorbable antimicrobial-eluting bone void filler billed with C1602; intraoperative debridement and preparation of the defect; placement of the orthopedic/device/drug matrix into the void to deliver local antibiotic and support bone healing; closure and postoperative monitoring for wound healing and signs of systemic infection; postoperative orders may include systemic antibiotics guided by cultures and serial radiographs to assess material resorption and bone healing. Typical settings are inpatient acute care hospitals and ambulatory surgical centers for selected stable cases; implanted material is provided by the facility or supplied by the surgeon/vendor depending on procurement and billing arrangements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |