Summary & Overview
HCPCS C9789: Instillation of Anti-neoplastic Agent into Renal Pelvis
HCPCS Level II code C9789 denotes the instillation of an anti-neoplastic pharmacologic or biologic agent into the renal pelvis, including any imaging guidance and volumetric measurement if performed. This code captures a targeted intrarenal oncologic therapy technique used in urologic oncology for localized management of malignancy or tumor-related conditions affecting the renal pelvis. Nationally, accurate coding of these procedures affects claims processing, clinical documentation, and reporting for specialty urology and interventional oncology services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The report provides a concise overview of how the service is described in coding terms, payer coverage considerations, and common billing modifiers associated with procedure-based services.
Readers will learn the clinical context and service setting associated with the code, expected sites of service, and what elements the code includes (imaging guidance and volumetric measurement). The publication outlines relevant benchmarks and policy considerations at a national level, highlights potential documentation elements necessary to support medical necessity, and summarizes common modifiers used in practice. Data not available in the input will be noted where applicable.
Billing Code Overview
HCPCS Level II code C9789 describes the instillation of an anti-neoplastic pharmacologic or biologic agent into the renal pelvis, performed by any method. The code includes all imaging guidance used to place and monitor the instillation and also includes volumetric measurement if performed as part of the procedure.
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Service type: Localized oncologic therapy / intrarenal instillation
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Typical site of service: Hospital outpatient department, ambulatory surgical center, or specialized infusion suite where image-guided urologic or interventional procedures are performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of non–muscle-invasive urothelial carcinoma of the renal pelvis presents for intrarenal instillation of an anti‑neoplastic biologic agent via percutaneous nephrostomy. The patient has undergone diagnostic imaging demonstrating a localized superficial tumor confined to the renal pelvis and has a functioning nephrostomy tube placed for urinary diversion. On the day of service the interventional radiology team confirms tube patency, performs contrast fluoroscopic assessment of the collecting system, measures instilled volume if clinically indicated, and instills the prescribed anti‑neoplastic agent into the renal pelvis under imaging guidance. Post‑procedure monitoring includes brief observation for pain, pyrexia, hematuria, and signs of systemic absorption. The workflow typically involves pre‑procedure verification of medication, informed consent, sterile preparation at bedside or in a procedure suite, imaging guidance (fluoroscopy or ultrasound), instillation with dwell time per oncology protocol, documentation of volumetric measurement if performed, and discharge instructions with follow‑up with the treating urologist and medical oncologist.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Generally not appended; placeholder in provided list |
22 |