How To Use HCPCS Code C9603

HCPCS code C9603 describes a specific medical procedure known as percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery. This code is used to identify and bill for the additional branches of a major coronary artery that require treatment during the same procedure as the primary procedure.

1. What is HCPCS C9603?

HCPCS code C9603 is a specific code used in medical coding to identify and bill for the additional branches of a major coronary artery that require treatment during the same procedure as the primary procedure. It is important to note that this code should only be used when the primary procedure involves percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty.

2. Official Description

The official description of HCPCS code C9603 is “Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, 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 by accessing the patient’s major coronary artery through a percutaneous approach.
2. A catheter with a specialized atherectomy device is then inserted into the artery.
3. The atherectomy device is used to remove plaque and other obstructions from the artery, improving blood flow.
4. After the atherectomy, a drug-eluting intracoronary stent is placed in the artery to help keep it open.
5. If necessary, the provider may also perform coronary angioplasty to further widen the artery and improve blood flow.
6. If additional branches of the major coronary artery require treatment during the same procedure, they should be listed separately in addition to the code for the primary procedure.

4. When to use HCPCS code C9603

HCPCS code C9603 should be used when the primary procedure involves percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty, and there are additional branches of a major coronary artery that require treatment during the same procedure. It is important to list these additional branches separately in addition to the code for the primary procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9603, healthcare providers should ensure that the medical documentation clearly supports the need for the additional branch treatment during the same procedure. This may include detailed descriptions of the specific branches treated, the rationale for their treatment, and any relevant clinical findings. It is important to accurately document the services provided to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9603 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.

7. Medicare and Insurance Coverage

HCPCS code C9603 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 on billing and reimbursement for this code.

8. Examples

Here are five examples of when HCPCS code C9603 should be billed:

1. A patient undergoes percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty for the treatment of a major coronary artery. During the procedure, two additional branches of the artery are identified and treated. In this case, HCPCS code C9603 should be used to bill for the additional branch treatments.
2. A patient with multiple blockages in their major coronary artery undergoes percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty. The procedure involves treating three additional branches of the artery. HCPCS code C9603 should be used to bill for the additional branch treatments.
3. During a percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty procedure, the provider identifies and treats an additional branch of the major coronary artery. HCPCS code C9603 should be used to bill for this additional branch treatment.
4. A patient undergoes percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty for the treatment of a major coronary artery. The procedure involves treating two additional branches of the artery. HCPCS code C9603 should be used to bill for the additional branch treatments.
5. During a percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, and coronary angioplasty procedure, the provider identifies and treats three additional branches of the major coronary artery. HCPCS code C9603 should be used to bill for the additional branch treatments.