Question 1

What is HCPCS code C9607?

Accepted Answer

HCPCS code C9607 is "Perc d-e cor revasc chro sin". Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel

Question 2

What category is C9607 in?

Accepted Answer

C9607 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9607?

Accepted Answer

Use C9607 when billing for perc d-e cor revasc chro sin. 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 C9607?

Accepted Answer

Common ICD-10 diagnosis codes used with C9607 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 C9607 covered by Medicare?

Accepted Answer

Coverage for C9607 (Perc d-e cor revasc chro sin) 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 C9607?

Accepted Answer

Documentation for C9607 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).