Question 1

What is HCPCS code C7540?

Accepted Answer

HCPCS code C7540 is "Rmv&rplc pm dul w/l vnt lead". Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator, dual lead system, with insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system)

Question 2

What category is C7540 in?

Accepted Answer

C7540 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C7540?

Accepted Answer

Use C7540 when billing for rmv&rplc pm dul w/l vnt 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 C7540?

Accepted Answer

Common ICD-10 diagnosis codes used with C7540 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 C7540 covered by Medicare?

Accepted Answer

Coverage for C7540 (Rmv&rplc pm dul w/l vnt 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 C7540?

Accepted Answer

Documentation for C7540 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).