How To Use HCPCS Code C9754

HCPCS code C9754 describes the creation of an arteriovenous fistula through a percutaneous procedure. This code includes all imaging and radiologic supervision and interpretation, as well as any secondary procedures performed to redirect blood flow, such as transluminal balloon angioplasty or coil embolization. It is important for medical coders to understand the specific meaning and usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS C9754?

HCPCS code C9754 is used to identify the creation of an arteriovenous fistula through a percutaneous procedure. An arteriovenous fistula is a surgical connection between an artery and a vein, typically created to provide access for hemodialysis treatment in patients with end-stage renal disease. This code encompasses the entire process of creating the fistula, including any necessary imaging and radiologic supervision and interpretation. It also includes any secondary procedures performed to redirect blood flow, such as transluminal balloon angioplasty or coil embolization.

2. Official Description

The official description of HCPCS code C9754 is as follows: “Creation of arteriovenous fistula, percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed).” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The provider begins by identifying a suitable artery and vein for the creation of the arteriovenous fistula.
2. Anesthesia is administered to ensure patient comfort during the procedure.
3. A percutaneous approach is used, meaning that the procedure is performed through the skin and without the need for open surgery.
4. The provider makes a small incision near the selected artery and vein.
5. A needle or catheter is inserted into the artery and vein, allowing access to the blood vessels.
6. The provider then creates a connection between the artery and vein, typically by suturing them together.
7. Imaging techniques, such as ultrasound or fluoroscopy, may be used during the procedure to guide the placement of the needle or catheter and ensure proper positioning of the arteriovenous fistula.
8. If necessary, secondary procedures such as transluminal balloon angioplasty or coil embolization may be performed to redirect blood flow and optimize the function of the arteriovenous fistula.
9. The incision is closed, and appropriate dressings are applied to promote healing.

4. When to use HCPCS code C9754

HCPCS code C9754 should be used when a healthcare provider performs a percutaneous procedure to create an arteriovenous fistula. This code is applicable to direct fistula creation at any site in the body. It is important to note that this code specifically includes all imaging and radiologic supervision and interpretation, as well as any secondary procedures performed to redirect blood flow. Medical coders should ensure that the documentation supports the use of this code and that all necessary components are included in the claim.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9754, healthcare providers should ensure that the documentation clearly supports the performance of the procedure, including the creation of the arteriovenous fistula, any imaging or radiologic supervision and interpretation, and any secondary procedures performed. It is important to include detailed information about the site of the fistula creation, the specific techniques used, and any additional procedures performed. Proper documentation is crucial for accurate billing and reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9754 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 1996. As of June 30, 2020, this code has been terminated. The termination of a code means that it is no longer valid for use in billing and reimbursement. Medical coders should ensure that they are using the most up-to-date codes and follow any coding guidelines or instructions provided by relevant authorities.

7. Medicare and Insurance Coverage

HCPCS code C9754 is assigned a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code for this code is A, which means that it is not applicable as HCPCS priced under one methodology. It is important for healthcare providers to check with Medicare and other insurance carriers to determine coverage and reimbursement policies for this specific code. Each carrier may have its own guidelines and requirements for payment.

8. Examples

Here are five examples of scenarios in which HCPCS code C9754 may be used:

1. A patient with end-stage renal disease undergoes a percutaneous procedure to create an arteriovenous fistula in the arm. The procedure includes ultrasound guidance and transluminal balloon angioplasty to optimize blood flow.
2. A patient requires an arteriovenous fistula for hemodialysis access due to kidney failure. The provider performs a percutaneous procedure to create the fistula in the leg, using fluoroscopy for guidance and coil embolization to redirect blood flow.
3. A patient with renal failure needs an arteriovenous fistula for dialysis treatment. The provider performs a percutaneous procedure to create the fistula in the neck, utilizing ultrasound guidance and coil embolization to ensure proper blood flow.
4. A patient with end-stage renal disease undergoes a percutaneous procedure to create an arteriovenous fistula in the abdomen. The procedure includes fluoroscopic guidance and transluminal balloon angioplasty to optimize blood flow.
5. A patient requires an arteriovenous fistula for hemodialysis access. The provider performs a percutaneous procedure to create the fistula in the chest, using ultrasound guidance and coil embolization to redirect blood flow.