Question 1

What is HCPCS code C7537?

Accepted Answer

HCPCS code C7537 is "Insrt atril pm w/l vent lead". Insertion of new or replacement of permanent pacemaker with atrial transvenous electrode(s), with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (e.g., for upgrade to dual chamber system)

Question 2

What category is C7537 in?

Accepted Answer

C7537 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C7537?

Accepted Answer

Use C7537 when billing for insrt atril pm w/l vent lead. 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

What ICD-10 codes are commonly used with C7537?

Accepted Answer

Common ICD-10 diagnosis codes used with C7537 include: G90.01 (Carotid sinus syncope), I25.2 (Old myocardial infarction), I25.5 (Ischemic cardiomyopathy), I42.0 (Dilated cardiomyopathy). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is C7537 covered by Medicare?

Accepted Answer

Coverage for C7537 (Insrt atril pm w/l vent lead) 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 6

What documentation is required for C7537?

Accepted Answer

Documentation for C7537 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).