Question 1

What is HCPCS code C7544?

Accepted Answer

HCPCS code C7544 is "Ercp rmv calc pancreatoscopy". Endoscopic retrograde cholangiopancreatography (ercp) with removal of calculi/debris from biliary/pancreatic duct(s), with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s)

Question 2

What category is C7544 in?

Accepted Answer

C7544 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C7544?

Accepted Answer

Use C7544 when billing for ercp rmv calc pancreatoscopy. 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 C7544 covered by Medicare?

Accepted Answer

Coverage for C7544 (Ercp rmv calc pancreatoscopy) 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 C7544?

Accepted Answer

Documentation for C7544 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).