Question 1

What is HCPCS code C9761?

Accepted Answer

HCPCS code C9761 is "Cysto, litho, vacuum kidney". Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable (must use a steerable ureteral catheter)

Question 2

What category is C9761 in?

Accepted Answer

C9761 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C9761?

Accepted Answer

Use C9761 when billing for cysto, litho, vacuum kidney. 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 C9761 covered by Medicare?

Accepted Answer

Coverage for C9761 (Cysto, litho, vacuum kidney) 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 C9761?

Accepted Answer

Documentation for C9761 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).