Question 1

What is HCPCS code C9754?

Accepted Answer

HCPCS code C9754 is "Perc av fistula, direct". Creation of arteriovenous fistula,  percutaneous; direct, any site, including all imaging and radiologic supervision and interpretation, when performed and secondary procedures to redirect blood flow (e.g., transluminal balloon angioplasty, coil embolization, when performed)

Question 2

What category is C9754 in?

Accepted Answer

C9754 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9754?

Accepted Answer

Use C9754 when billing for perc av fistula, direct. 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 C9754 covered by Medicare?

Accepted Answer

Coverage for C9754 (Perc av fistula, direct) 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 C9754?

Accepted Answer

Documentation for C9754 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).