How To Use HCPCS Code C9767

HCPCS code C9767 describes a specific procedure known as revascularization, endovascular, open or percutaneous, of the lower extremity artery(ies), except tibial/peroneal. This procedure involves the use of intravascular lithotripsy and transluminal stent placement(s), as well as atherectomy and angioplasty within the same vessel(s), when performed. It is important for medical coders to understand the details and appropriate usage of this code to ensure accurate billing and reimbursement.

1. What is HCPCS C9767?

HCPCS code C9767 is used to identify a specific procedure performed on the lower extremity artery(ies), excluding the tibial/peroneal arteries. This procedure involves revascularization, which is the restoration of blood flow to the affected area. It can be performed through open surgery or percutaneously, using minimally invasive techniques. The procedure also includes the use of intravascular lithotripsy, transluminal stent placement(s), atherectomy, and angioplasty within the same vessel(s), if necessary.

2. Official Description

The official description of HCPCS code C9767 is “Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, 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 procedure by accessing the affected lower extremity artery(ies) through an open incision or percutaneously using a catheter.
2. Intravascular lithotripsy is performed to break up any calcified plaque or stones present in the artery(ies).
3. Transluminal stent(s) are then placed within the artery(ies) to help keep them open and maintain blood flow.
4. Atherectomy is performed to remove any remaining plaque or blockages from the artery(ies).
5. If necessary, angioplasty is performed within the same vessel(s) to further widen the artery(ies) and improve blood flow.
6. The procedure is completed, and the incision is closed or the catheter is removed.

4. When to use HCPCS code C9767

HCPCS code C9767 should be used when documenting and billing for the specific procedure described in the official description. It is important to ensure that the procedure meets the criteria outlined in the code description, including the use of intravascular lithotripsy, transluminal stent placement(s), atherectomy, and angioplasty within the same vessel(s), if performed. Medical coders should review the patient’s medical records and procedure notes to determine if this code is appropriate based on the documented procedure.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9767, healthcare providers should ensure that the necessary documentation is included in the patient’s medical records. This documentation should support the performance of the specific procedure described in the code, including details on the use of intravascular lithotripsy, transluminal stent placement(s), atherectomy, and angioplasty within the same vessel(s), if applicable. It is important to accurately capture the details of the procedure to ensure proper reimbursement.

6. Historical Information and Code Maintenance

HCPCS code C9767 was added to the Healthcare Common Procedure Coding System on January 01, 1985. It has an effective date of January 01, 1996. The code has a pricing indicator code of 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, indicating that it is not applicable as HCPCS priced under one methodology. The Medicare Carriers Manual Reference Section Number for this code is 2130, providing additional guidance for Medicare billing.

7. Medicare and Insurance Coverage

Medicare coverage for HCPCS code C9767 may vary depending on the specific circumstances and guidelines set forth by Medicare. It is important for healthcare providers to review the Medicare coverage policies and guidelines to determine if this code is eligible for reimbursement. The pricing indicator code and multiple pricing indicator code provide additional information on how the service or supply is priced by Medicare or other insurers.

8. Examples

Here are five examples of when HCPCS code C9767 may be billed:

1. A patient with peripheral artery disease undergoes revascularization of the lower extremity artery using intravascular lithotripsy, transluminal stent placement, atherectomy, and angioplasty within the same vessel(s).
2. A patient with atherosclerosis of the lower extremity artery requires open revascularization with the use of intravascular lithotripsy, transluminal stent placement, atherectomy, and angioplasty within the same vessel(s).
3. A patient with a blocked lower extremity artery undergoes percutaneous revascularization with the use of intravascular lithotripsy, transluminal stent placement, atherectomy, and angioplasty within the same vessel(s).
4. A patient with a history of lower extremity artery disease undergoes a repeat revascularization procedure using intravascular lithotripsy, transluminal stent placement, atherectomy, and angioplasty within the same vessel(s).
5. A patient with a chronic total occlusion of the lower extremity artery requires revascularization with the use of intravascular lithotripsy, transluminal stent placement, atherectomy, and angioplasty within the same vessel(s).