How To Use HCPCS Code C1722

HCPCS code C1722 describes a specific medical device known as a cardioverter-defibrillator. This implantable device is designed to treat and prevent life-threatening arrhythmias by delivering electrical shocks to the heart. In this article, we will explore the details of HCPCS code C1722, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS C1722?

HCPCS code C1722 is used to identify a single-chamber cardioverter-defibrillator that is implanted in a patient. This device is capable of monitoring the heart’s rhythm and delivering electrical shocks when necessary to restore a normal heartbeat. It is an essential tool in the management of life-threatening arrhythmias and can significantly improve patient outcomes.

2. Official Description

The official description of HCPCS code C1722 is “Cardioverter-defibrillator, single chamber (implantable).” The short description for this code is “Parenteral supp not othrws c.” This description accurately reflects the purpose and nature of the device.

3. Procedure

1. Before the implantation procedure, the patient is typically evaluated to determine their eligibility for a cardioverter-defibrillator.
2. An incision is made in the chest to access the heart.
3. The cardioverter-defibrillator leads are inserted into the heart through veins and positioned in the appropriate chamber.
4. The device is then connected to the leads and secured in a pocket created under the skin.
5. The incision is closed, and the patient is monitored to ensure proper functioning of the device.

4. When to use HCPCS code C1722

HCPCS code C1722 should be used when billing for the implantation of a single-chamber cardioverter-defibrillator. It is important to ensure that the device meets the specific requirements outlined in the code description to accurately report the procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1722, healthcare providers need to document the medical necessity of the procedure and provide supporting documentation. This may include the patient’s medical history, diagnostic test results, and any other relevant information. Additionally, providers should follow the appropriate coding and billing guidelines set forth by Medicare or other insurance carriers.

6. Historical Information and Code Maintenance

HCPCS code C1722 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. As indicated by the action code N, no maintenance actions have been taken for this code. This means that there have been no updates or revisions since its addition to the coding system.

7. Medicare and Insurance Coverage

HCPCS code C1722 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code 57 indicates that the device is priced by carriers using methods other than the Medicare fee schedule. The multiple pricing indicator code A signifies that the code is not applicable for pricing under multiple methodologies.

8. Examples

Here are five examples of scenarios in which HCPCS code C1722 should be billed:

1. A 65-year-old patient with a history of ventricular tachycardia undergoes the implantation of a single-chamber cardioverter-defibrillator.
2. A 50-year-old patient with a previous cardiac arrest receives a single-chamber cardioverter-defibrillator to prevent future life-threatening arrhythmias.
3. A 45-year-old patient with a congenital heart condition requires the implantation of a single-chamber cardioverter-defibrillator for ongoing monitoring and treatment.
4. A 70-year-old patient with heart failure and a high risk of sudden cardiac death undergoes the implantation of a single-chamber cardioverter-defibrillator.
5. A 55-year-old patient with a history of ventricular fibrillation receives a single-chamber cardioverter-defibrillator to provide immediate treatment in case of future arrhythmias.