How To Use HCPCS Code C9766

HCPCS code C9766 describes a specific procedure known as revascularization, endovascular, open or percutaneous, of the lower extremity artery(ies), except tibial/peroneal, with intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed. This code is used to identify and bill for the medical services provided during this procedure.

1. What is HCPCS C9766?

HCPCS code C9766 is a specific code used in medical coding to identify and describe the procedure of revascularization, endovascular, open or percutaneous, of the lower extremity artery(ies), except tibial/peroneal, with intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed. It is important for medical coders to accurately assign this code to ensure proper billing and reimbursement for the services provided.

2. Official Description

The official description of HCPCS code C9766 is “Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel(s), when performed.” The short description for this code is “Enteral supp not otherwise c.”

3. Procedure

1. The procedure of HCPCS code C9766 involves revascularization, which is the restoration of blood flow to a blocked or narrowed artery in the lower extremity.
2. This can be done through an endovascular approach, where a catheter is inserted into the artery through a small incision and guided to the site of the blockage.
3. Once the catheter is in place, intravascular lithotripsy is performed, which uses sonic pressure waves to break up calcified plaque within the artery.
4. Following lithotripsy, atherectomy is performed to remove any remaining plaque or blockage from the artery.
5. If necessary, angioplasty may also be performed within the same vessel(s) to further open up the artery and improve blood flow.
6. The specific steps and techniques used during the procedure may vary depending on the patient’s condition and the provider’s preferences.

4. When to use HCPCS code C9766

HCPCS code C9766 should be used when the provider performs revascularization of the lower extremity artery(ies), except tibial/peroneal, using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed. It is important to review the official description and short description of the code to ensure that the procedure performed aligns with the code’s definition.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9766, healthcare providers should ensure that the necessary documentation is in place to support the services provided. This may include operative reports, procedure notes, and any other relevant documentation that demonstrates the medical necessity and appropriateness of the procedure. It is important to follow the specific billing guidelines and requirements of the payer, as well as any applicable local coverage determinations or national coverage determinations.

6. Historical Information and Code Maintenance

HCPCS code C9766 was added to the Healthcare Common Procedure Coding System on January 1, 1985. It has an effective date of January 1, 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 to the code since its addition.

7. Medicare and Insurance Coverage

HCPCS code C9766 may be payable by Medicare and other insurance carriers. The pricing indicator code 57 indicates that the code is priced by other carriers. The multiple pricing indicator code A indicates that the code is not applicable as HCPCS priced under one methodology. It is important for healthcare providers to verify the coverage and reimbursement policies of each individual payer to ensure proper billing and reimbursement for the services provided.

8. Examples

Here are five examples of when HCPCS code C9766 should be billed:

1. A patient with peripheral artery disease undergoes revascularization of the lower extremity artery using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed.
2. A patient with a chronic total occlusion in the lower extremity artery undergoes revascularization using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed.
3. A patient with a severe blockage in the lower extremity artery undergoes revascularization using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed.
4. A patient with recurrent stenosis in the lower extremity artery undergoes revascularization using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed.
5. A patient with rest pain and tissue loss in the lower extremity undergoes revascularization using intravascular lithotripsy and atherectomy, including angioplasty within the same vessel(s) when performed.