Question 1

What is HCPCS code C9601?

Accepted Answer

HCPCS code C9601 is "Perc drug-el cor stent bran". Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (list separately in addition to code for primary procedure)

Question 2

What category is C9601 in?

Accepted Answer

C9601 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9601?

Accepted Answer

Use C9601 when billing for perc drug-el cor stent bran. 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 C9601?

Accepted Answer

Common ICD-10 diagnosis codes used with C9601 include: I20.0 (Unstable angina), I20.1 (Angina pectoris with documented spasm), I20.81 (Angina pectoris with coronary microvascular dysfunction), I20.89 (Other forms of angina pectoris). Always ensure proper medical documentation supports the medical necessity for the HCPCS code being billed.

Question 5

Is C9601 covered by Medicare?

Accepted Answer

Coverage for C9601 (Perc drug-el cor stent bran) 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 C9601?

Accepted Answer

Documentation for C9601 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).