C9285: Lidocaine 70 mg/tetracaine 70 mg, per patch
C9285 is a HCPCS Level II code for lidocaine 70 mg/tetracaine 70 mg, per patch. 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 2026Q4-Oct. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits: units per day
The most units of C9285 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
- 2 units MAI 3: Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 2 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 2026Q4.
The CMS record for C9285
- Long descriptor
- Lidocaine 70 mg/tetracaine 70 mg, per patch
- Short descriptor
- Patch, lidocaine/tetracaine
- Added
- July 1, 2011
- 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 C9285
HCPCS has no hierarchy: related items simply sit next to each other in the numbering. If C9285 is not quite right, the correct code is very often within a few positions of it.
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