Summary & Overview
HCPCS C9143: Cocaine Hydrochloride Nasal Solution, 1 mg
HCPCS Level II code C9143 denotes cocaine hydrochloride nasal solution (numbrino), 1 mg, a unitized topical nasal anesthetic and vasoconstrictor used in ENT and procedural settings. Nationally, this code is relevant for billing and clinical documentation when topical cocaine is supplied or administered during nasal procedures that require local anesthesia and bleeding control. Proper coding supports accurate service reporting and influences coverage and payment decisions across major payers.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a national overview of how C9143 is classified and used clinically, the typical sites of service, and the operational considerations for billing. It summarizes common modifiers and payer considerations where applicable, while noting areas where input data is not available.
Readers will learn the clinical context for C9143, the service types and settings in which it is applied, which major payers are relevant to coverage discussions, and what information is missing from the provided input. The piece highlights implications for coding accuracy and documentation practices essential to procedural workflows and claims submission.
Billing Code Overview
HCPCS Level II code C9143 describes cocaine hydrochloride nasal solution (numbrino), 1 mg. The service represented is the provision or administration of a topical nasal anesthetic/vasoconstrictor formulation containing cocaine hydrochloride at a 1 mg unit, typically used in otolaryngology or procedural settings requiring local nasal anesthesia or hemostasis. The typical site of service is ambulatory surgical centers, hospital outpatient departments, and physician offices where nasal procedures or endoscopic examinations are performed.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology clinic or an emergency department with active epistaxis, nasal mucosal bleeding during nasal endoscopy, or requiring topical local vasoconstriction and anesthesia for minor intranasal procedures. The clinician prepares and administers C9143 (cocaine hydrochloride nasal solution, 1 mg) as a topical agent applied intranasally via soaked pledget or spray immediately before nasal packing, cauterization, diagnostic nasal endoscopy, or minor intranasal foreign body removal. Monitoring includes vital signs and level of consciousness due to the sympathomimetic effects of cocaine; continuous cardiac and oxygenation monitoring is typical for patients with cardiovascular risk factors. Documentation includes indication, dose administered, route (intranasal), time, patient tolerance, and any adverse events. Billing uses the HCPCS Level II code C9143 for the drug supply; associated procedural CPT codes and applicable modifiers are appended per payer and facility rules. Typical sites of service are outpatient otolaryngology clinics, emergency departments, and ambulatory surgical centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds typical service for the associated procedure during which is administered. |