How To Use HCPCS Code C9765

HCPCS code C9765 describes a specific procedure called revascularization, which is performed on the lower extremity artery/arteries, excluding the tibial/peroneal arteries. This procedure involves the use of endovascular techniques, either open or percutaneous, to restore blood flow to the affected arteries. It includes intravascular lithotripsy, transluminal stent placement(s), and angioplasty within the same vessel(s), if necessary.

1. What is HCPCS C9765?

HCPCS code C9765 is a specific alphanumeric code used in medical coding to identify the procedure of revascularization performed on the lower extremity artery/arteries, excluding the tibial/peroneal arteries. This code is used to accurately document and bill for this particular procedure.

2. Official Description

The official description of HCPCS code C9765 is “Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed.” The short description for this code is “Parenteral supp not othrws c.”

3. Procedure

1. The provider begins the revascularization procedure by accessing the affected lower extremity artery/arteries using either an open or percutaneous approach.
2. Intravascular lithotripsy is then performed to break up any calcified plaque or obstructions within the artery/arteries.
3. Transluminal stent placement(s) is done to support the artery and maintain blood flow.
4. If necessary, angioplasty may be performed within the same vessel(s) to further widen the artery and improve blood flow.

4. When to use HCPCS code C9765

HCPCS code C9765 should be used when documenting and billing for the revascularization procedure performed on the lower extremity artery/arteries, excluding the tibial/peroneal arteries. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9765, healthcare providers need to document the details of the revascularization procedure, including the approach used (open or percutaneous), the specific artery/arteries treated, the use of intravascular lithotripsy, transluminal stent placement(s), and any additional angioplasty performed within the same vessel(s). It is crucial to provide accurate and detailed documentation to support the medical necessity of the procedure.

6. Historical information and Code Maintenance

HCPCS code C9765 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.

7. Medicare and Insurance Coverage

HCPCS code C9765 is assigned a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code A signifies that it is not applicable as HCPCS priced under one methodology. Medicare and other insurance coverage for this procedure may vary, and it is important to check with the specific payer for their coverage policies and reimbursement rates.

8. Examples

Here are five examples of scenarios where HCPCS code C9765 may be used:

1. A patient with severe peripheral artery disease undergoes revascularization of the lower extremity artery using endovascular techniques, including intravascular lithotripsy, transluminal stent placement(s), and angioplasty within the same vessel(s).
2. An individual with a history of lower extremity arterial occlusion requires revascularization to restore blood flow and prevent further complications.
3. A patient with critical limb ischemia undergoes the revascularization procedure to improve blood flow and prevent the need for amputation.
4. An individual with claudication experiences significant pain and limited mobility due to arterial blockages, necessitating revascularization.
5. A diabetic patient with peripheral arterial disease undergoes revascularization to promote wound healing and prevent the progression of complications.