How To Use HCPCS Code C1766

HCPCS code C1766 describes an introducer/sheath that is used for intracardiac electrophysiological procedures. This steerable guiding sheath is designed to assist in the placement of catheters and other devices during these procedures. In this article, we will explore the details of HCPCS code C1766, including its official description, procedure, usage guidelines, billing requirements, historical information, and coverage by Medicare and other insurance providers.

1. What is HCPCS C1766?

HCPCS code C1766 is used to identify an introducer/sheath that is specifically designed for intracardiac electrophysiological procedures. This steerable guiding sheath is different from the peel-away type and is used to facilitate the placement of catheters and other devices during these procedures. It is important to note that this code is not applicable for enteral supplies or any other unrelated services.

2. Official Description

The official description of HCPCS code C1766 is “Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins by preparing the patient for the intracardiac electrophysiological procedure.
2. An incision is made at the appropriate site to access the blood vessels.
3. The introducer/sheath, guided by imaging techniques, is inserted into the blood vessel.
4. Using the steerable feature of the sheath, the provider navigates it to the desired location within the heart.
5. Once the sheath is properly positioned, catheters and other devices can be inserted through it to perform the necessary diagnostic or therapeutic procedures.
6. After the procedure is completed, the sheath is carefully removed from the patient.

4. When to use HCPCS code C1766

HCPCS code C1766 should be used when an intracardiac electrophysiological procedure is performed using a steerable guiding sheath that is not of the peel-away type. It is important to ensure that the procedure meets the specific criteria outlined in the code description. Providers should review the patient’s medical records and documentation to confirm the appropriateness of using this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C1766, healthcare providers should ensure that the necessary documentation is in place to support the use of this code. This may include the procedure notes, operative reports, and any other relevant documentation that demonstrates the medical necessity and appropriateness of using the steerable guiding sheath for the intracardiac electrophysiological procedure. It is important to follow the specific billing guidelines and requirements of the payer to ensure accurate and timely reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C1766 was added to the Healthcare Common Procedure Coding System on January 01, 1985. Since its addition, there have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. It is important to note that this code has been in use for a significant period of time, and providers should stay updated on any changes or revisions that may occur in the future.

7. Medicare and Insurance Coverage

HCPCS code C1766 is eligible for coverage by Medicare and other insurance providers. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means that it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidance on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C1766 should be billed:

1. A patient undergoes an intracardiac electrophysiological procedure to diagnose and treat arrhythmias. The provider uses a steerable guiding sheath (C1766) to facilitate the placement of catheters and perform the necessary interventions.
2. A patient with a history of heart disease requires an intracardiac electrophysiological procedure to assess the function of the cardiac conduction system. The provider utilizes a steerable guiding sheath (C1766) to navigate the catheters and perform the necessary diagnostic tests.
3. A patient presents with recurrent episodes of syncope, and an intracardiac electrophysiological procedure is recommended to identify the underlying cause. The provider uses a steerable guiding sheath (C1766) to guide the catheters and perform the necessary ablation therapy.
4. A patient with a known cardiac arrhythmia requires a repeat intracardiac electrophysiological procedure to assess the effectiveness of previous interventions. The provider utilizes a steerable guiding sheath (C1766) to access the heart and perform the necessary mapping and ablation procedures.
5. A patient with a congenital heart defect requires an intracardiac electrophysiological procedure to assess the function of the repaired heart structures. The provider uses a steerable guiding sheath (C1766) to navigate the catheters and perform the necessary diagnostic tests.