Summary & Overview
HCPCS C9813: Perforated Continuous Infusion Catheter Set, Non-Opioid Device
HCPCS Level II code C9813 denotes a perforated continuous infusion catheter set (e.g., infiltralong), including all components, identified as a qualifying non-opioid medical device for post-surgical pain relief under section 4135 of the CAA, 2023. The code captures supply of an infusion delivery system intended to provide localized non-opioid analgesia following surgery, a clinical tool increasingly relevant amid efforts to reduce opioid exposure after procedures. Nationally, this code matters as payers adapt coverage and payment policies for novel non-opioid technologies that support multimodal pain management.
Key payers reviewed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical role of the device, payer coverage considerations, and the policy context tied to the CAA 2023 non-opioid device provision. The publication summarizes typical sites of service, common billing and coding implications where available, and identifies gaps in publicly available coverage guidance.
This report provides practitioners, billing professionals, and policy stakeholders with benchmarks for understanding the code’s purpose, the payer landscape nationally, and the regulatory backdrop influencing adoption and reimbursement of non-opioid post-surgical infusion devices.
Billing Code Overview
HCPCS Level II code C9813 describes a perforated continuous infusion catheter set (e.g. infiltralong), including all components, non-opioid medical device. This device is designated as a qualifying Medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the CAA, 2023.
Service Type: Medical device infusion delivery set for non-opioid post-surgical analgesia
Typical Site of Service: Hospital outpatient departments, ambulatory surgery centers, and other post-surgical care settings where continuous non-opioid analgesia is delivered
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient undergoes elective open colectomy for malignancy and has moderate to severe post-operative pain. To provide localized, non-opioid analgesia and reduce systemic opioid exposure in accordance with the CHRONICALLY Act and section 4135 of the CAA, 2023, the surgical team places a perforated continuous infusion catheter (e.g., infiltralong) into the wound bed or epidural/soft-tissue plane at the conclusion of the procedure. The device is connected to an ambulatory infusion pump that delivers a continuous infusion of a qualifying non-opioid analgesic agent. Nursing documents device insertion time, catheter and dressing appearance, infusion parameters, patient education on device management, and planned duration of use (typically 48–72 hours or as clinically indicated). Device removal occurs in the inpatient setting or during early outpatient follow-up; documentation includes removal time, catheter integrity, pain scores before/after removal, and any complications such as site infection or catheter dislodgement.
Typical site of service: Hospital inpatient or outpatient surgical center (post-operative recovery area) with potential short-stay outpatient follow-up.
Service type: Provision and management of a qualifying non-opioid continuous infusion catheter set for post-surgical pain relief, including insertion-related handling, monitoring, and removal as part of post-operative analgesia management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
24 |