How To Use HCPCS Code C9602

HCPCS code C9602 describes the procedure of percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed, specifically for a single major coronary artery or branch. This code is used to identify and bill for this specific combination of procedures performed on a patient’s coronary arteries.

1. What is HCPCS C9602?

HCPCS code C9602 is a specific code used in medical coding to identify and bill for the procedure of percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed, for a single major coronary artery or branch. It is important for medical coders to accurately assign this code to ensure proper reimbursement for the services provided.

2. Official Description

The official description of HCPCS code C9602 is “Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The procedure of HCPCS code C9602 involves percutaneous transluminal coronary atherectomy, which is a minimally invasive procedure used to remove plaque buildup in the coronary arteries. This is done using a specialized catheter with a cutting device.
2. During the procedure, a drug eluting intracoronary stent is also placed in the affected artery. This stent helps to keep the artery open and prevent further blockages.
3. If necessary, coronary angioplasty may also be performed during the same procedure. This involves using a balloon-tipped catheter to widen the narrowed artery and improve blood flow.
4. The entire procedure is performed percutaneously, meaning that it is done through a small incision or puncture in the skin, without the need for open surgery.

4. When to use HCPCS code C9602

HCPCS code C9602 should be used when the provider performs percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed, specifically for a single major coronary artery or branch. It is important to review the documentation and ensure that all the necessary components of the procedure are met before assigning this code.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9602, healthcare providers need to ensure that the documentation supports the performance of percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty when performed on a single major coronary artery or branch. The medical record should clearly indicate the necessity and medical decision-making behind the procedure.

6. Historical Information and Code Maintenance

HCPCS code C9602 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 system.

7. Medicare and Insurance Coverage

HCPCS code C9602 is covered by Medicare and other insurance carriers. The pricing indicator code 57 indicates that the service is priced by other carriers. The multiple pricing indicator code A means that the code is not applicable as HCPCS priced under one methodology. Healthcare 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 C9602 should be billed:

1. A patient undergoes percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty for a significant blockage in a major coronary artery.
2. A patient with a single major coronary artery or branch requires percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty to improve blood flow.
3. A patient with a history of coronary artery disease undergoes percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty for a new blockage in a major coronary artery.
4. A patient with unstable angina undergoes percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty to relieve symptoms and improve blood flow.
5. A patient with a single major coronary artery or branch requires percutaneous transluminal coronary atherectomy, drug eluting intracoronary stent placement, and coronary angioplasty as part of a planned revascularization procedure.