How To Use HCPCS Code C9607

HCPCS code C9607 describes the percutaneous transluminal revascularization of chronic total occlusion in the coronary artery, coronary artery branch, or coronary artery bypass graft. This procedure involves the use of a combination of drug-eluting intracoronary stent, atherectomy, and angioplasty to restore blood flow in a single vessel.

1. What is HCPCS C9607?

HCPCS code C9607 is a specific code used to identify the percutaneous transluminal revascularization procedure for chronic total occlusion in the coronary artery. It is used when a combination of drug-eluting intracoronary stent, atherectomy, and angioplasty is performed in a single vessel. This code is important for accurate medical coding and billing purposes.

2. Official Description

The official description of HCPCS code C9607 is “Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel.” The short description is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure begins with the insertion of a catheter into the affected coronary artery.
2. A guidewire is then advanced through the catheter and positioned across the chronic total occlusion.
3. A balloon catheter is then inserted and inflated to open the occluded artery.
4. If necessary, a drug-eluting intracoronary stent may be placed to help keep the artery open.
5. Atherectomy, which involves the removal of plaque from the artery, may also be performed.
6. Finally, angioplasty may be performed to further widen the artery and improve blood flow.

4. When to use HCPCS code C9607

HCPCS code C9607 should be used when performing percutaneous transluminal revascularization for chronic total occlusion in the coronary artery, coronary artery branch, or coronary artery bypass graft. It is important to ensure that the procedure involves a combination of drug-eluting intracoronary stent, atherectomy, and angioplasty in a single vessel.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9607, healthcare providers need to document the details of the procedure, including the specific vessel involved, the use of drug-eluting intracoronary stent, atherectomy, and angioplasty, and any other relevant information. It is important to provide accurate and detailed documentation to support the medical necessity of the procedure.

6. Historical Information and Code Maintenance

HCPCS code C9607 was added to the Healthcare Common Procedure Coding System on January 01, 1985. 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 stay updated with any changes or revisions to the code to ensure accurate coding and billing.

7. Medicare and Insurance Coverage

HCPCS code C9607 is covered by Medicare. The pricing indicator code 57 indicates that the service is priced by other carriers. The multiple pricing indicator code A means that it is not applicable as HCPCS priced under one methodology. It is important to check with individual insurance providers for coverage and reimbursement guidelines.

8. Examples

Here are some examples of when HCPCS code C9607 should be billed:

1. A patient with chronic total occlusion in a single coronary artery undergoes percutaneous transluminal revascularization using a drug-eluting intracoronary stent, atherectomy, and angioplasty.
2. A patient with chronic total occlusion in a coronary artery branch undergoes percutaneous transluminal revascularization using a drug-eluting intracoronary stent, atherectomy, and angioplasty.
3. A patient with chronic total occlusion in a coronary artery bypass graft undergoes percutaneous transluminal revascularization using a drug-eluting intracoronary stent, atherectomy, and angioplasty.
4. A patient with chronic total occlusion in a single coronary artery undergoes percutaneous transluminal revascularization using a drug-eluting intracoronary stent and angioplasty without atherectomy.
5. A patient with chronic total occlusion in a coronary artery branch undergoes percutaneous transluminal revascularization using a drug-eluting intracoronary stent and atherectomy without angioplasty.