C9046 — Cocaine hydrochloride nasal solution (goprelto), 1 mg
C9046 is a HCPCS Level II code for cocaine hydrochloride nasal solution (goprelto), 1 mg. It belongs to the Outpatient Prospective Payment System section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of C9046 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 160 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 160 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for C9046
- Long descriptor
- Cocaine hydrochloride nasal solution (goprelto), 1 mg
- Short descriptor
- Cocaine hcl nasal (goprelto)
- Added
- April 1, 2019
- BETOS
- O1E
- Pricing indicator
- 53 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Statute.
Codes adjacent to C9046
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If C9046 is not quite right, the correct code is very often within a few positions of it.
- C9038Injection, mogamulizumab-kpkc, 1 mgterminated
- C9039Injection, plazomicin, 5 mgterminated
- C9040Injection, fremanezumab-vfrm, 1mgterminated
- C9041Injection, coagulation factor xa (recombinant), inactivated (andexxa), 10 mgterminated
- C9042Injection, bendamustine hcl (belrapzo), 1 mgterminated
- C9043Injection, levoleucovorin, 1 mgterminated
- C9044Injection, cemiplimab-rwlc, 1 mgterminated
- C9045Injection, moxetumomab pasudotox-tdfk, 0.01 mgterminated
- C9047Injection, caplacizumab-yhdp, 1 mg
- C9048Dexamethasone, lacrimal ophthalmic insert, 0.1 mgterminated
- C9049Injection, tagraxofusp-erzs, 10 mcgterminated
- C9050Injection, emapalumab-lzsg, 1 mgterminated
- C9051Injection, omadacycline, 1 mgterminated
- C9052Injection, ravulizumab-cwvz, 10 mgterminated
- C9053Injection, crizanlizumab-tmca, 1 mgterminated
- C9054Injection, lefamulin (xenleta), 1 mgterminated
Questions about C9046
What is HCPCS code C9046?
C9046 is a HCPCS Level II code for cocaine hydrochloride nasal solution (goprelto), 1 mg. It sits in the Outpatient Prospective Payment System section.
Does Medicare cover C9046?
The CMS HCPCS file marks C9046 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.