How To Use HCPCS Code C9792

HCPCS code C9792 describes a specific procedure for symptomatic New York Heart Association (NYHA) class II, III, IVA heart failure. This code is used to identify the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access, including all imaging necessary to intra procedurally map the coronary sinus for optimal shunt placement. The procedure is performed under general anesthesia in an approved investigational device exemption (IDE) study.

1. What is HCPCS C9792?

HCPCS code C9792 is a specific code used to identify the transcatheter implantation of a left atrial to coronary sinus shunt for patients with symptomatic heart failure. This procedure involves accessing the coronary sinus through the jugular vein and placing a shunt to improve blood flow and alleviate symptoms associated with heart failure.

2. Official Description

The official description of HCPCS code C9792 is “Blinded or nonblinded procedure for symptomatic New York Heart Association (NYHA) class II, III, IVA heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein access, including all imaging necessary to intra procedurally map the coronary sinus for optimal shunt placement (e.g., tee or ice ultrasound, fluoroscopy), performed under general anesthesia in an approved investigational device exemption (IDE) study).” The short description is “Parenteral supp not othrws c.”

3. Procedure

1. The procedure begins with the patient under general anesthesia.
2. The provider accesses the jugular vein to gain access to the coronary sinus.
3. Imaging techniques such as transesophageal echocardiography (TEE), intracardiac echocardiography (ICE), ultrasound, and fluoroscopy are used to map the coronary sinus and determine the optimal placement of the shunt.
4. The provider then implants the left atrial to coronary sinus shunt.
5. Throughout the procedure, the patient’s vital signs and anesthesia are monitored.
6. Once the procedure is complete, the patient is monitored in a recovery area before being discharged.

4. When to use HCPCS code C9792

HCPCS code C9792 should be used when performing the transcatheter implantation of a left atrial to coronary sinus shunt for patients with symptomatic NYHA class II, III, IVA heart failure. This procedure is specifically intended for use in approved investigational device exemption (IDE) studies.

5. Billing Guidelines and Documentation Requirements

When billing for HCPCS code C9792, healthcare providers should ensure that the following documentation is included:

• Documentation supporting the patient’s symptomatic NYHA class II, III, IVA heart failure.
• Documentation of the use of jugular vein access and the transcatheter implantation of the left atrial to coronary sinus shunt.
• Imaging reports and documentation of the intra procedural mapping of the coronary sinus.
• Documentation of the use of general anesthesia.
• Documentation of the approved investigational device exemption (IDE) study.

6. Historical Information and Code Maintenance

HCPCS code C9792 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.

7. Medicare and Insurance Coverage

HCPCS code C9792 is covered by Medicare. The pricing indicator code for this code is 57, which indicates that it is priced by other carriers. The multiple pricing indicator code is A, which means it is not applicable as HCPCS priced under one methodology. Providers should refer to the Medicare Carriers Manual Reference Section Number 2130 for additional guidance on billing and coverage.

8. Examples

Here are five examples of when HCPCS code C9792 should be billed:

1. A 65-year-old patient with symptomatic NYHA class III heart failure undergoes the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access as part of an approved investigational device exemption (IDE) study.
2. A 55-year-old patient with symptomatic NYHA class IVA heart failure undergoes the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access, including all necessary imaging, under general anesthesia as part of an approved investigational device exemption (IDE) study.
3. A 70-year-old patient with symptomatic NYHA class II heart failure undergoes the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access, including all necessary imaging, under general anesthesia as part of an approved investigational device exemption (IDE) study.
4. A 60-year-old patient with symptomatic NYHA class III heart failure undergoes the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access, including all necessary imaging, under general anesthesia as part of an approved investigational device exemption (IDE) study.
5. A 50-year-old patient with symptomatic NYHA class IVA heart failure undergoes the transcatheter implantation of a left atrial to coronary sinus shunt using jugular vein access, including all necessary imaging, under general anesthesia as part of an approved investigational device exemption (IDE) study.