How To Use HCPCS Code C9608

HCPCS code C9608 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. The code is used to identify each additional coronary artery, coronary artery branch, or bypass graft that is treated during the primary procedure.

1. What is HCPCS C9608?

HCPCS code C9608 is a specific code used in medical coding to identify the percutaneous transluminal revascularization of chronic total occlusion in the coronary artery, coronary artery branch, or coronary artery bypass graft. It is used to indicate the use of a combination of drug-eluting intracoronary stent, atherectomy, and angioplasty during the procedure. This code is used to identify each additional coronary artery, coronary artery branch, or bypass graft that is treated in addition to the primary procedure.

2. Official Description

The official description of HCPCS code C9608 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; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure)”. The short description for this code is “Enteral supp not otherwise c”.

3. Procedure

1. The provider begins the procedure by accessing the occluded coronary artery, coronary artery branch, or coronary artery bypass graft.
2. A guidewire is then inserted into the occluded vessel to create a pathway for the subsequent steps.
3. A balloon catheter is advanced over the guidewire and positioned at the site of the occlusion.
4. The balloon is inflated to compress the plaque and open up the vessel.
5. If necessary, an atherectomy device may be used to remove any remaining plaque or blockage.
6. A drug-eluting intracoronary stent is then inserted and deployed at the site of the occlusion to help keep the vessel open.
7. The procedure is repeated for each additional coronary artery, coronary artery branch, or bypass graft that requires treatment.

4. When to use HCPCS code C9608

HCPCS code C9608 should be used when performing percutaneous transluminal revascularization of chronic total occlusion in the coronary artery, coronary artery branch, or coronary artery bypass graft. It is important to use this code for each additional coronary artery, coronary artery branch, or bypass graft that is treated during the primary procedure. This code should not be used for any other procedures or services.

5. Billing Guidelines and Documentation Requirements

When billing for the procedure identified by HCPCS code C9608, healthcare providers should ensure that the necessary documentation is included in the medical record. This documentation should support the medical necessity of the procedure and provide details on the specific coronary artery, coronary artery branch, or bypass graft that was treated. It is also important to accurately report the number of additional coronary arteries, coronary artery branches, or bypass grafts that were treated during the primary procedure.

6. Historical Information and Code Maintenance

HCPCS code C9608 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. The code is priced by other carriers, as indicated by the pricing indicator code 57. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. The Medicare Carriers Manual Reference Section Number for this code is 2130.

7. Medicare and Insurance Coverage

Medicare and other insurance providers may provide coverage for the procedure identified by HCPCS code C9608. The specific coverage instructions may vary, so it is important to review the individual payer’s guidelines and policies. The pricing of this service or supply is determined by other carriers, and the code is not priced under a single methodology. Healthcare providers should verify the coverage and reimbursement policies with the respective payers.

8. Examples

Here are five examples of when HCPCS code C9608 should be billed:

1. A patient undergoes percutaneous transluminal revascularization of a chronic total occlusion in the left anterior descending coronary artery, and an additional coronary artery branch in the right coronary artery is also treated during the same procedure.
2. A patient with a coronary artery bypass graft presents with chronic total occlusion in one of the grafts. The provider performs percutaneous transluminal revascularization of the occluded graft and also treats an additional coronary artery branch in the native coronary artery.
3. A patient has chronic total occlusion in two separate coronary artery branches. The provider performs percutaneous transluminal revascularization of both occluded branches during the same procedure.
4. A patient with a previous coronary artery bypass graft presents with chronic total occlusion in one of the grafts and an additional occlusion in a native coronary artery. The provider performs percutaneous transluminal revascularization of both occlusions during the same procedure.
5. A patient has chronic total occlusion in a coronary artery branch and an additional occlusion in a bypass graft. The provider performs percutaneous transluminal revascularization of both occlusions during the same procedure.