How To Use HCPCS Code C9601

HCPCS code C9601 describes the percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed, for each additional branch of a major coronary artery. This code is used to identify and bill for the specific procedure of placing a drug-eluting stent in an additional branch of a major coronary artery, in addition to the primary procedure.

1. What is HCPCS C9601?

HCPCS code C9601 is a specific code used in medical coding to identify and bill for the percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed, for each additional branch of a major coronary artery. It is important to note that this code is used in addition to the primary procedure code to indicate the placement of a stent in an additional branch of a major coronary artery.

2. Official Description

The official description of HCPCS code C9601 is “Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)”. The short description for this code is “Parenteral supp not othrws c”.

3. Procedure

1. The provider begins the procedure by accessing the patient’s major coronary artery through a percutaneous transcatheter approach.
2. A drug-eluting intracoronary stent is then inserted into the artery to help keep it open and improve blood flow.
3. If necessary, coronary angioplasty may be performed to widen the artery and improve blood flow.
4. This procedure is specifically performed for each additional branch of a major coronary artery, in addition to the primary procedure.
5. The provider ensures that the stent is properly placed and functioning before completing the procedure.

4. When to use HCPCS code C9601

HCPCS code C9601 should be used when the provider is performing the percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed, for each additional branch of a major coronary artery. This code is used in addition to the primary procedure code to indicate the placement of a stent in an additional branch of a major coronary artery.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9601, healthcare providers need to ensure that the documentation supports the performance of the procedure for each additional branch of a major coronary artery. The medical record should include detailed information about the procedure, including the specific branches of the major coronary artery where the stent was placed. It is important to accurately document the medical necessity and appropriateness of the procedure to support reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9601 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. There have been no maintenance actions taken for this code, as indicated by the action code N, which means no maintenance for this code. This code is still in use and has not been terminated or revised since its addition.

7. Medicare and Insurance Coverage

HCPCS code C9601 is covered by Medicare and other insurance carriers. 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 it is not applicable as HCPCS priced under one methodology. Healthcare providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for specific guidelines and instructions on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C9601 should be billed:

1. A patient undergoes a percutaneous transcatheter placement of a drug-eluting intracoronary stent in the left anterior descending artery, in addition to the primary procedure.
2. A patient requires the placement of a drug-eluting intracoronary stent in the right coronary artery and the left circumflex artery, in addition to the primary procedure.
3. A patient undergoes a percutaneous transcatheter placement of drug-eluting intracoronary stents in multiple branches of a major coronary artery, in addition to the primary procedure.
4. A patient requires the placement of a drug-eluting intracoronary stent in a branch of a major coronary artery that was not initially planned during the primary procedure.
5. A patient undergoes a percutaneous transcatheter placement of a drug-eluting intracoronary stent in a branch of a major coronary artery that was previously stented, in addition to the primary procedure.