Question 1

What is HCPCS code C1605?

Accepted Answer

HCPCS code C1605 is "Pmkr, dual, leadless". Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation

Question 2

What category is C1605 in?

Accepted Answer

C1605 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C1605?

Accepted Answer

Use C1605 when billing for pmkr, dual, leadless. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is C1605 covered by Medicare?

Accepted Answer

Coverage for C1605 (Pmkr, dual, leadless) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for C1605?

Accepted Answer

Documentation for C1605 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).