Summary & Overview
HCPCS C9359: Porous Collagen Matrix Bone Void Filler Putty
HCPCS Level II code C9359 designates a porous purified collagen matrix bone void filler sold as putty (Integra Mozaik or Integra OS), reported per 0.5 cc. This code identifies a specific class of osteoconductive scaffold used to fill bone defects during surgical procedures, serving as a scaffold to support bone healing. Nationally, precise coding for bone graft substitutes affects device tracking, billing clarity, and consistency in reporting device-utilization across surgical specialties.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, typical clinical settings where the product is used (hospital OR, ambulatory surgical center, outpatient surgical clinic), and the service type (bone graft substitute/osteoconductive scaffold placement).
The publication provides benchmarks and policy-relevant context related to device coding, utilization patterns, and payer coverage considerations where available. It also outlines clinical context for use in bone voids and surgically created defects. Data not available in the input is clearly noted where applicable.
Billing Code Overview
HCPCS Level II code C9359 describes a porous purified collagen matrix bone void filler sold as putty, specifically identified as Integra Mozaik Osteoconductive Scaffold Putty or Integra OS Osteoconductive Scaffold Putty, billed per 0.5 cc.
Service Type: Bone graft substitute / osteoconductive scaffold placement
Typical Site of Service: Hospital operating room, ambulatory surgical center, or outpatient surgical clinic
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with a chronic nonunion of the distal radius following prior open reduction internal fixation presents for operative management. The orthopedic surgeon plans revision fixation with debridement of the nonunion site and augmentation of the bone void using a porous purified collagen matrix bone void filler (C9359) measured in 0.5 cc increments to support osteoconduction and promote bone healing. The patient undergoes general anesthesia in an ambulatory surgery center. Intraoperative workflow includes exposure of the nonunion, scar and fibrous tissue excision, preparation of bone ends, placement of internal fixation hardware as indicated, and packing of the bone defect with the collagen scaffold putty. The implant quantity is documented in 0.5 cc units and billed with C9359 per 0.5 cc. Typical documentation includes procedure note, implant log with lot numbers and volumes, operative estimates of defect size, and postoperative instructions for weight bearing, follow-up radiographs, and infection surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier (default) | Use when no special circumstances apply and standard billing applies for the implant supply. |