hospital physician coding guide...pm-97 disclaimer while terumo medical corporation has made...

2018 HOSPITAL & PHYSICIAN CODING GUIDE

PM-00097

DisclaimerWhile Terumo Medical Corporation has made reasonable efforts to ensure the accuracy of the information set forth herein, Terumo does not guarantee reimbursement coverage or amounts for any product or procedure nor does Terumo recommend any particular product or procedure for any individual patient. The information described herein is provided solely as a guide for Terumo products and is based on publicly available information from CMS. It is the responsibility of the provider to report codes that accurately describe the products, procedures, and individual patient’s medical condition(s). Providers should contact the appropriate payers directly if they have questions or need specific information. Terumo Medical Corporation does not promote the use of its products outside of the uses or indications as described in the applicable labeling.

PM-00097

TABLE OF CONTENTS

C-Code Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

AZUR® Peripheral HydroCoil Embolization System . . . . . . . . . . . . . . . . . . . . . . . 4

MISAGO® RX Self-expanding Peripheral Stent . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

METACROSS™ RX PTA Balloon Dilatation Catheter . . . . . . . . . . . . . . . . . . . . . . 6

PRIORITYONE® Aspiration Catheter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

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C-CODE SUMMARY

Overview:The Centers for Medicare and Medicaid Services (CMS) requires the reporting of appropriate C-Codes for all device-dependent Ambulatory Payment Classifications (APCs) for hospital oupatient services. If a hospital outpatient bill includes a device-related CPT/HCPCS II procedure code but the C-Code for the associated device is not present, the claim is edited and returned to the hospital. Furthermore, if a C-Code is billed without the appropriate procedure code, the claim will be returned. For the majoirty of C-Codes, the hospital does not receive additional reimbursement for devices. However, the C-Codes are required as CMS is collecting charge data for these devices for use in setting future APC payment rates.

C-Codes are only reportable for hospital oupatient procedures, and not all devices have applicable C-Codes. This guide includes a summary list of Terumo products and the corresponding C-Code. This guide is intended to provide general coding guidance. The full list of C-Codes is avalable at https://www .cms .gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Downloads/Complet-list-DeviceCats-OPPS .pdf .1 Physicians and hospitals are responsible for selecting and reporting the codes that most accurately desribe the procedure(s) performed. Providers should follow coding guidelines from the insurer as well as review the appropriate coding authorities for further guidance.

Terumo Product C-Code Description

Closure/Compression Devices

ANGIO-SEAL® VIP

C1760 Closure device, vascular (implantable/insertable)ANGIO-SEAL® STS Plus

ANGIO-SEAL® Evolution™

TR BAND® Radial Compression Device N/A There is no applicable C code for this product

Sheaths

VADO® Steerable Sheath C1766 Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away

PINNACLE® DESTINATION® Guiding Sheath C1887 Catheter, guiding (may include infusion/perfusion capability)

PINNACLE PRECISION ACCESS SYSTEM® Sheath

C1894 Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser

PINNACLE® R/O II Radiopaque Marker Introducer Sheath

PINNACLE® TIF TIP™ Introducer Sheath - Peripheral

PINNACLE® TIF TIP™ Introducer Sheath - Coronary

GLIDEACCESS® System - Micro Accessing Kits

GLIDESHEATH™ Introducer Sheath - Hydrophilic Coated

GLIDESHEATH SLENDER® Introducer Sheath

SOLOPATH® Balloon Expandable TransFemoral System

SOLOPATH® Re-collapsible Balloon Access System

Disposable Inflation Device N/A Included in C code of introducer/sheath

Guidewires

GLIDEWIRE® Hydrophilic Coated Guidewire - Regular

C1769 Guidewire

GLIDEWIRE® Hydrophilic Coated Guidewire - Shapeable Tip

GLIDEWIRE® with Stiff Shaft Guidewire

GLIDEWIRE® Gold Hydrophilic Coated Guidewire

GLIDEWIRE® GT Guidewire

GLIDEWIRE ADVANTAGE® Guidewire

RUNTHROUGH® NS Coronary Guidewire - Extra Floppy

RUNTHROUGH® NS HYPERCOAT™ Coronary Guidewire

RUNTHROUGH® NS Coronary Guidewire

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Terumo Product C-Code Description

Microcatheters

PROGREAT® MicrocatheterC1887 Catheter, guiding (may include infusion/perfusion capability)

PROGREAT® Coaxial Microcatheter System

Catheters - Coronary

PRIORITYONE® Aspiration Catheter C1757 Catheter, thrombectomy/embolectomy

FINECROSS® MG Coronary Micro-Guide Catheter

C1887 Catheter, guiding (may include infusion/perfusion capability)OPTITORQUE® Diagnostic Catheter - TR Shape

OPTITORQUE® Diagnostic Catheter - COM Shape

HEARTRAIL® III Guiding Catheter

Catheters - Peripheral

NAVICROSS® Catheter

C1887 Catheter, guiding (may include infusion/perfusion capability)GLIDECATH® Hydrophilic Coated Catheter

GLIDECATH® Yashiro Catheter

GLIDECATH® XP Hydrophilic Coated Catheter

Embolotherapy

AZUR® Peripheral HydroCoil Embolization System

N/A There is no applicable C code for this product

AZUR® Detachment Controller

AZUR® Detachable Hydrocoil

AXUR® CX Detachable Hydrocoil

AZUR® Pushable Hydrocoil

AZUR® Framing Coil

Interventional Devices

MISAGO® RX Self-expanding Peripheral Stent C1876 Stent, non-coated/non-covered, with delivery system

METACROSS™ RX PTA Balloon Dilatation Catheter C1725 Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)

Note: Stents packaged with delivery systems generally include the following components: stent mounted or unmounted on a balloon angioplasty catheter, introducer, and sheath. These components should not be reported separately.

Accessories

Obturators

N/A There is no applicable C code for this product

TORQUE™ Device

C-CODE SUMMARY

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Hospital Inpatient

Possible ICD-10 Procedure Codes Description Typical MS-DRG Assignment **

04LE3DT Occlusion of Left Uterine Artery with Intraluminal Device, Percutaneous Approach749750

Other Female Reproductive System O.R. Procedures with CC/MCCOther Female Reproductive System O.R. Procedures without CC/MCC04LF3DU Occlusion of Right Uterine Artery with Intraluminal Device, Percutaneous Approach

* Due to the number of vessels, arteries and veins this device can be placed, they are not included here. Please refer to your ICD-10-PCS materials for the appropriate code(s) that describe where the devices were placed** MS-DRG assignment is based on patient specific diagnoses and procedures performed during the hospital stay.Source: DRG Expert, 2017, Optum360

Hospital Outpatient

CPT™ Code Description APC Description Status Indicator

37241

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)

5183 Level 3 Endovascular Procedures J1

37242

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)

37243Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction

37244Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation

Status Indicator “J1”: Paid under OPPS; all covered Part B services on the claim are packaged with the primary “J1” service for the claim, except services with OPPS SI=F,G, H, L and U; ambulance services; diagnostic and screening mammography; all preventive services; and certain Part B inpatient services.Source: CMS-1678-FC, Addendum A, B

Physician

CPT™ Code Description Status Indicator Total Non-Facility RVUs Total Facility

RVUs

37241

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; venous, other than hemorrhage (eg, congenital or acquired venous malformations, venous and capillary hemangiomas, varices, varicoceles)

A 134.18 12.91

37242

Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (eg, congenital or acquired arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)

A 207.62 13.95

37243Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction

A 275.01 16.38

37244Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation

A 191.70 19.37

Status Indicator “A”: Active code - these codes are separately payable under the Physician Fee ScheduleSource: CMS-1676-F, Addendum B

CPT is a trademark of the American Medical Association

AZUR®

Peripheral HydroCoil Embolization System

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Hospital Inpatient


047K3DZ Dilation of Right Femoral Artery with Intraluminal Device, Percutaneous Approach RT

252

253

254

Other Vascular Procedures with MCC

Other Vascular Procedures with CC

Other Vascular Procedures without MCC/CC

047L3DZ Dilation of Left Femoral Artery with Intraluminal Device, Percutaneous Approach LT

047M3DZ Dilation of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach RT

047N3DZ Dilation of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach LT

04CK3ZZ Extirpation of Matter from Right Femoral Artery, Percutaneous Approach RT

04CL3ZZ Extirpation of Matter from Left Femoral Artery, Percutaneous Approach LT

04CM3ZZ Extirpation of Matter from Right Popliteal Artery, Percutaneous Approach RT

04CN3ZZ Extirpation of Matter from Left Popliteal Artery, Percutaneous Approach

** MS-DRG assignment is based on patient specific diagnoses and procedures performed during the hospital stay.Source: DRG Expert, 2017, Optum360

Hospital Outpatient


37226Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed


37227Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed


Status Indicator “J1”: Paid under OPPS; all covered Part B services on the claim are packaged with the primary “J1” service for the claim, except services with OPPS SI=F,G, H, L and U; ambulance services; diagnostic and screening mammography; all preventive services; and certain Part B inpatient services.Source: CMS-1678-FC, Addendum A, B

Physician

CPT™ Code Description Status Indicator Total Non-Facility RVUs Total Facility

RVUs


A 252.77 15.25


A 418.38 21.26

Status Indicator “A”: Active code - these codes are separately payable under the Physician Fee ScheduleSource: CMS-1676-F


MISAGO® RXSelf-Expanding Peripheral Stent

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Hospital Inpatient

Possible ICD-10 Procedure Codes Description Typical MS-DRG Assignment

047C3DZ Dilation of Right Common Iliac Artery with Intraluminal Device, Percutaneous Approach

252

253

254

Other Vascular Procedures with MCC

Other Vascular Procedures with CC

Other Vascular Procedures without MCC/CC

047D3DZ Dilation of Left Common Iliac Artery with Intraluminal Device, Percutaneous Approach

047E3DZ Dilation of Right Internal Iliac Artery with Intraluminal Device, Percutaneous Approach

047F3DZ Dilation of Left Internal Iliac Artery with Intraluminal Device, Percutaneous Approach

047H3DZ Dilation of Right External Iliac Artery with Intraluminal Device, Percutaneous Approach

047J3DZ Dilation of Left External Iliac Artery with Intraluminal Device, Percutaneous Approach

047K3DZ Dilation of Right Femoral Artery with Intraluminal Device, Percutaneous Approach

047L3DZ Dilation of Left Femoral Artery with Intraluminal Device, Percutaneous Approach

047M3DZ Dilation of Right Popliteal Artery with Intraluminal Device, Percutaneous Approach

047N3DZ Dilation of Left Popliteal Artery with Intraluminal Device, Percutaneous Approach

04CK3ZZ Extirpation of Matter from Right Femoral Artery, Percutaneous Approach

04CL3ZZ Extirpation of Matter from Left Femoral Artery, Percutaneous Approach

04CM3ZZ Extirpation of Matter from Right Popliteal Artery, Percutaneous Approach


04793ZZ Dilation of Right Renal Artery, Percutaneous Approach

047A3ZZ Dilation of Left Renal Artery, Percutaneous Approach

047B3ZZ Dilation of Inferior Mesenteric Artery, Percutaneous Approach

047C3ZZ Dilation of Right Common Iliac Artery, Percutaneous Approach

047D3ZZ Dilation of Left Common Iliac Artery, Percutaneous Approach

047E3ZZ Dilation of Right Internal Iliac Artery, Percutaneous Approach

047F3ZZ Dilation of Left Internal Iliac Artery, Percutaneous Approach

047H3ZZ Dilation of Right External Iliac Artery, Percutaneous Approach

047J3ZZ Dilation of Left External Iliac Artery, Percutaneous Approach

047K3ZZ Dilation of Right Femoral Artery, Percutaneous Approach

047L3ZZ Dilation of Left Femoral Artery, Percutaneous Approach

047M3ZZ Dilation of Right Popliteal Artery, Percutaneous Approach

047N3ZZ Dilation of Left Popliteal Artery, Percutaneous Approach

047P3ZZ Dilation of Right Anterior Tibial Artery, Percutaneous Approach

047Q3ZZ Dilation of Left Anterior Tibial Artery, Percutaneous Approach

047R3ZZ Dilation of Right Posterior Tibial Artery, Percutaneous Approach

047S3ZZ Dilation of Left Posterior Tibial Artery, Percutaneous Approach

047T3ZZ Dilation of Right Peroneal Artery, Percutaneous Approach

047U3ZZ Dilation of Left Peroneal Artery, Percutaneous Approach

047V3ZZ Dilation of Right Foot Artery, Percutaneous Approach

047W3ZZ Dilation of Left Foot Artery, Percutaneous Approach

047Y3ZZ Dilation of Lower Artery, Percutaneous Approach

Source: DRG Expert, 2017, Optum360

METACROSS™ RXPTA Balloon Dilatation Catheter

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Hospital Outpatient


37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty 5192 Level 2 Endovascular Procedures J1

37221Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed


+37222Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure)

N/A N

+37223

Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)

N/A N

37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty 5192 Level 2 Endovascular Procedures J1

37225Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed






37246

Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery


37247 Each additional artery N/A N

Status Indicator “J1”: Paid under OPPS; all covered Part B services on the claim are packaged with the primary “J1” service for the claim, except services with OPPS SI=F,G, H, L and U; ambulance services; diagnostic and screening mammography; all preventive services; and certain Part B inpatient services.Status Indicator “N”: Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment.Source: CMS-1678-FC, Addendum A, B

Physician

CPT™ Code Description Status Indicator

Total Non-Facility RVUs

Total Facility RVUs

37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal angioplasty A 86.71 11.72

37221 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed A 128.63 14.46

+37222 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure) A 24.37 5.45

+37223 Revascularization, endovascular, open or percutaneous, iliac artery, each additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in addition to code for primary procedure) A 72.08 6.23

37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty A 105.29 12.97

37225 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with atherectomy, includes angioplasty within the same vessel, when performed A 309.18 17.69

37226 Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed A 252.77 15.25


A 418.38 21.26

37246 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery

A 60.61 10.14

37247 A 24.49 4.98

Status Indicator “A”: Active code - these codes are separately payable under the Physician Fee Schedule“+” indicates the CPT code is an add-on codeSource: CMS-1676-F, Addendum B CPT is a trademark of the American Medical Association

METACROSS™ RXPTA Balloon Dilatation Catheter

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PRIORITYONE®

Aspiration Catheter

Hospital Inpatient


02CW3ZZ Extirpation of Matter from Thoracic Aorta, Percutaneous Approach

These procedure codes can map to various MS-DRGs based on the

patient’s diagnoses and other procedures being performed

03C23ZZ Extirpation of Matter from Innominate Artery, Percutaneous Approach

03C33ZZ Extirpation of Matter from Right Subclavian Artery, Percutaneous Approach

03C43ZZ Extirpation of Matter from Left Subclavian Artery, Percutaneous Approach

03C53ZZ Extirpation of Matter from Right Axillary Artery, Percutaneous Approach

03C63ZZ Extirpation of Matter from Left Axillary Artery, Percutaneous Approach

03C73ZZ Extirpation of Matter from Right Brachial Artery, Percutaneous Approach

03C83ZZ Extirpation of Matter from Left Brachial Artery, Percutaneous Approach

03C93ZZ Extirpation of Matter from Right Ulnar Artery, Percutaneous Approach

03CA3ZZ Extirpation of Matter from Left Ulnar Artery, Percutaneous Approach

03CB3ZZ Extirpation of Matter from Right Radial Artery, Percutaneous Approach

03CC3ZZ Extirpation of Matter from Left Radial Artery, Percutaneous Approach

03CH3ZZ Extirpation of Matter from Right Common Carotid Artery, Percutaneous Approach

03CJ3ZZ Extirpation of Matter from Left Common Carotid Artery, Percutaneous Approach

03CK3ZZ Extirpation of Matter from Right Internal Carotid Artery, Percutaneous Approach

03CL3ZZ Extirpation of Matter from Left Internal Carotid Artery, Percutaneous Approach

03CM3ZZ Extirpation of Matter from Right External Carotid Artery, Percutaneous Approach

03CN3ZZ Extirpation of Matter from Left External Carotid Artery, Percutaneous Approach

04C03ZZ Extirpation of Matter from Abdominal Aorta, Percutaneous Approach

04C13ZZ Extirpation of Matter from Celiac Artery, Percutaneous Approach

04C53ZZ Extirpation of Matter from Superior Mesenteric Artery, Percutaneous Approach

04C93ZZ Extirpation of Matter from Right Renal Artery, Percutaneous Approach

04CA3ZZ Extirpation of Matter from Left Renal Artery, Percutaneous Approach

04CB3ZZ Extirpation of Matter from Inferior Mesenteric Artery, Percutaneous Approach

04CC3ZZ Extirpation of Matter from Right Common Iliac Artery, Percutaneous Approach

04CD3ZZ Extirpation of Matter from Left Common Iliac Artery, Percutaneous Approach

04CE3ZZ Extirpation of Matter from Right Internal Iliac Artery, Percutaneous Approach

04CF3ZZ Extirpation of Matter from Left Internal Iliac Artery, Percutaneous Approach

04CH3ZZ Extirpation of Matter from Right External Iliac Artery, Percutaneous Approach

04CJ3ZZ Extirpation of Matter from Left External Iliac Artery, Percutaneous Approach

04CK3ZZ Extirpation of Matter from Right Femoral Artery, Percutaneous Approach

04CL3ZZ Extirpation of Matter from Left Femoral Artery, Percutaneous Approach

04CM3ZZ Extirpation of Matter from Right Popliteal Artery, Percutaneous Approach


04CP3ZZ Extirpation of Matter from Right Anterior Tibial Artery, Percutaneous Approach

04CQ3ZZ Extirpation of Matter from Left Anterior Tibial Artery, Percutaneous Approach

04CR3ZZ Extirpation of Matter from Right Posterior Tibial Artery, Percutaneous Approach

04CS3ZZ Extirpation of Matter from Left Posterior Tibial Artery, Percutaneous Approach

04CT3ZZ Extirpation of Matter from Right Peroneal Artery, Percutaneous Approach

04CU3ZZ Extirpation of Matter from Left Peroneal Artery, Percutaneous Approach

02C03ZZ Extirpation of Matter from Coronary Artery, One Site, Percutaneous Approach 246

247

248

249

Percutaneous CV procedure with DES with MCC, or 4+ vessels/stents

Percutaneous CV procedure with DES without MCC

Percutaneous CV procedure with non-DES with MCC, or 4+ vessels/stents

Percutaneous CV procedure with non-DES without MCC

X2C0361 Extirpation of Matter from Coronary Artery, One Site using Orbital Atherectomy Technology, Percutaneous Approach, New Technology Group 1

** MS-DRG assignment is based on patient specific diagnoses and procedures performed during the hospital stay.Source: DRG Expert, 2017, Optum360

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Hospital Outpatient


34001 Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision N/A C

34051 Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision N/A C

34101 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision 5184 Level 4 Vascular Procedures T

34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision 5184 Level 4 Vascular Procedures T

34151 Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision N/A C

34201 Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision 5184 Level 4 Vascular Procedures T

34203 Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision 5184 Level 4 Vascular Procedures T

92941

Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

N/A C

C9606

Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel


Status Indicator “C”: Not paid under OPPS; Admit patient; Bill as inpatient.Status Indicator “T”: Paid under OPPS; separate APC payment; multiple surgical reduction applies.Status Indicator “J1”: Paid under OPPS; all covered Part B services on the claim are packaged with the primary “J1” service for the claim, except services with OPPS SI=F,G, H, L and U; ambulance services; diagnostic and screening mammography; all preventive services; and certain Part B inpatient services.Source: CMS-1678-FC, Addendum A, B

Physician

CPT™ Code Description Status Indicator Total Facility RVUs

34001 Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or innominate artery, by neck incision A 26.57

34051 Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision A 28.78

34101 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, innominate, subclavian artery, by arm incision A 17.43

34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, by arm incision A 17.42

34151 Embolectomy or thrombectomy, with or without catheter; renal, celiac, mesentery, aortoiliac artery, by abdominal incision A 40.61

34201 Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision A 29.96

34203 Embolectomy or thrombectomy, with or without catheter; popliteal-tibio-peroneal artery, by leg incision A 27.74

92941

Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

A 19.33

Status Indicator “A”: Active code - these codes are separately payable under the Physician Fee Schedule.Source: CMS-1676-F, Addendum B


PRIORITYONE®

Aspiration Catheter

Reference: 1. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ HospitalOutpatientPPS/passthrough_payment.html

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hospital physician coding guide...pm-97 disclaimer while terumo medical corporation has made...

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