(Medicare Claims Processing Manual)

BOLD  codes  are still actively  receiving  pass-through payment.   Italicized  codes  have  received  preliminary  approval  for pass -through  payment.   * Refer to the definition  below  for further information  on this  device category code.  ** Effective 1/1/06 C1767 descriptor was changed for succeeding claims. See CR 4250, Jan. 3, 2006 for details.   *** Although the pass -through payment status for device category codes has expired, these codes  are still active and hospitals are still required to report the device category C -codes (except the brachytherapy source codes, which are separately paid under the OPPS) on claims when such devices  are used  in conjunction with  procedures  billed  and paid under  the OPPS.    # The brachytherapy descriptors were changed to the ones shown above, effective 7/1/07. These 6 brachytherapy source codes were paid as pass -through devices from 2000 through 2002, as noted. Beginning  in 2004, all brachytherapy sources  have been paid separately as non -pass-through items  from the procedure with which they are billed,  and additional brachytherapy source HCPCS codes  have been added for payment. To see the most current comprehensive list of brachytherapy source codes,  see the latest OPPS/ASC  final  rule.   60.4.3. - Explanations of Certain Terms/Definitions Related to Device Pass-Through Category Codes (Rev. 11150; Issued: 12- 10-21; Effective: 01- 01-22; Implementation: 01 -03-22)  3D mapping catheter (C1732)  - Refers to a catheter used for mapping the electrophysiologic properties of the heart. Signals are identified by a specialized catheter and changed into a 3- dimensional map of a specific region of the heart.   Adaptor for a pacing lead (C1883)  - Interpose d between an existing pacemaker lead and a new generator. The end of the adaptor lead has the appropriate connector pin that will enable utilization of the existing pacemaker lead with a new generator that has a different receptacle. These are required when a generator is replaced or when two leads are connected to the same port in the connector block.   Adhesion barrier (C1765) - A bioresorbable substance placed on and around the neural structures, which inhibits cell migration (fibroblasts) and minimizes s car tissue formation. It is principally used in spine surgeries, such as laminectomies and diskectomies.   Anchor for opposing bone -to-bone or soft tissue -to-bone (C1713)  - Implantable pins and/or screws that are used to oppose soft tissue -to-bone, tendon- to-bone, or bone -to-bone. Screws oppose tissues via drilling as follows: soft tissue -to-bone, tendon- to-bone, or bone -to-bone fixation. Pins are inserted or drilled into bone, principally with the intent to facilitate stabilization or oppose bone -to-bone. T his may include orthopedic plates with accompanying washers and nuts. This category also applies to synthetic bone substitutes that may be used to fill bony void or gaps (i.e., bone substitute implanted into a bony defect created from trauma or surgery).   Balloon dilatation catheter, non -vascular (C1726)  - Catheter used to dilate strictures or stenoses through the insertion of an uninflated balloon affixed to the end of a flexible catheter, followed by the inflation of the balloon at the specified site (e.g ., common bile duct, ureter, small or large intestine). [For the reporting of vascular balloon dilatation catheters, see category "Transluminal angioplasty catheter" (C1725 and C1885).]   Balloon tissue dissector catheter (C1727) - Balloon tipped catheter u sed to separate tissue planes, used in procedures such as hernia repairs.    Catheter, ablation, non -cardiac, endovascular (implantable) (C1888)   A radiofrequency or laser catheter designed to occlude or obliterate blood vessels (e.g., veins).   Cardioverter- defibrillator, other than single or dual chamber (C1882)  - Includes cardiac resynchronization devices.   Coated stent (C1874, C1875)  - Refers to a stent bonded with drugs (e.g., heparin), layered with biocompatible substances (e.g., phosphorylcholine), or with silicone or a silicone derivative (e.g., PTFE, polyurethane).  Connective tissue, human (C1762)  - These tissues include a natural, cellular collagen or extracellular matrix obtained from autologous rectus fascia, decellularized cadaveric fascia lata, or decellularized dermal tissue. They are intended to repair or support damaged or inadequate soft tissue. They are used to treat urinary incontinence resulting from hypermobility or Intrinsic Sphincter Deficiency (ISD), pelvic floor repair, or for implantation to reinforce soft tissues where weakness exists in the urological anatomy. Note this excludes those items that are used to replace skin. For reporting mesh when used to treat urinary incontinence, see the category Mesh. For reporting urinary incont inence repair device when used to treat urinary incontinence, see the category Urinary incontinence repair device.   Connective tissue, non -human (includes synthetic) (C1763)  - These tissues include a natural, acellular collagen matrix typically obtained from porcine or bovine small intestinal submucosa, or pericardium. This bio- material is intended to repair or support damaged or inadequate soft tissue. They are used to treat  urinary incontinence resulting from hypermobility or Intrinsic Sphincter Deficiency (ISD), pelvic floor repair, or for implantation to reinforce soft tissues where weakness exists in the urological or musculoskeletal anatomy. [This excludes those items th at are used to replace skin.] [For reporting mesh when used to treat urinary incontinence, see the category Mesh.] [For reporting urinary incontinence repair device when used to treat urinary incontinence, see the category Urinary incontinence repair device.]   Cool -tip electrophysiology catheter (C2630)  - Ablation catheter that contains a cooling mechanism and has temperature sensing capability.   Covered stent (C1874, C1875)  - Refers to a stent layered with silicone or a silicone derivative (e.g., PTFE, polyurethane).   Drainage catheter (C1729)  - Intended to be used for percutaneous drainage of fluids. (NOTE: This category does NOT include Foley catheters or suprapubic catheters. Refer to category C2627 to report suprapubic catheters.)   Electrophysiology  catheter (C1730, C1731, C1732, C1733, C2630)  - Assists in providing anatomic and physiologic information about the cardiac electrical conduction system. Electrophysiology catheters are categorized into two main groups:  (1) diagnostic catheters that are u sed for mapping, pacing, and/or recording only, and   (2) ablation (therapeutic) catheters that also have diagnostic capability.  The electrophysiology ablation catheters are distinct from non -cardiac ablation catheters.   Electrophysiology catheters designa ted as "cool -tip" refer to catheters with tips cooled by infused and/or circulating saline. Catheters designated as "other than cool -tip" refer to the termister tip catheter with temperature probe that measures temperature at the tissue catheter interface.   Embolization protective system (C1884)   A system designed and marketed for use to trap, pulverize, and remove atheromatous or thrombotic debris from the vascular system during an angioplasty, atherectomy, or stenting procedure.  Endoscope, single -use (i .e. disposable), Upper GI, imaging/illumination device (insertable) (C1784)  - Single -use (i.e.,disposable) endoscope with imaging, illumination, and working channels. This single -use (i.e., disposable) endoscope can be used for procedures that take place i n the Upper Gastrointestinal (GI) tract.  Extension for a pacing lead (C1883) - Provides additional length to an existing pacing lead but does not have the capability of an adaptor.   Extension for a neurostimulator lead (C1883)  - Conducts electrical pulses from the power source (generator or neurostimulator) to the lead. The terms neurostimulator and generator are used interchangeably.   Guiding catheter (C1887)  - Intended for the introduction of interventional/diagnostic devices into the coronary or peripher al vascular systems. It can be used to inject contrast material, function as a conduit through which other devices pass, and/or provide a mechanism for measuring arterial pressure, and maintain a pathway created by the guide wire during the performance of a procedure.   Infusion pump, non- programmable, temporary (implantable) (C2626)  - Short -term pain management system that is a component of a permanent implantable system used for chronic pain management.  Integrated keratoprosthesis (C1818)  The device is composed of a flexible, one -piece biocompatible polymer. It is used to replace diseased corneas in conditions and patient states where traditional corneal transplantation is not indicated or possible. Implantation of the procedure is done in a two- stage su rgical approach.   Intraocular lens (new technology) (C1780)  - Refers to the intraocular lenses approved by CMS as "new technology IOL." A list of these lenses is published periodically in the Federal Register. The latest publication can be found on page 25740 of the Federal Register notice dated May 3, 2000.  Intraoperative ocular device for detached retina (C1784) -  A perfluorocarbon substance instilled during a vitreoretinal procedure to treat detached retina.    Joint device (C1776)  - An artificial joint that is implanted in a patient. Typically, a joint device fun ctions as a substitute to its natural counterpart and is not used (as are anchors) to oppose soft tissue -to-bone, tendon- to-bone, or bone -to-bone.   Left ventricular coronary venous system lead (C1900)  - Designed for left heart placement in a cardiac vein v ia the coronary sinus and is intended to treat the symptoms associated with heart failure. This code should be reported with CPT codes 33224 or 33225.   Liquid pulmonary sealant (C2615) -  An absorbable, synthetic solution that forms a seal utilizing a photochemical polymerization process. It is used to seal visceral pleural air leaks incurred during pulmonary resection.   Material for vocal cord medialization, synthetic (C1878)  - Synthetic material that is composed of a non- absorbable substance such as silico ne and can be injected or implanted to result in vocal cord medialization.   Mesh (C1781)  - A mesh implant or synthetic patch composed of absorbable or non-absorbable material that is used to repair hernias, support weakened or attenuated tissue, cover tiss ue defects, etc. [For reporting connective tissue (human or non- human) when used to treat urinary incontinence, see the category Connective tissue, human or Connective tissue, non- human.] [For reporting urinary incontinence repair device when used to t reat urinary incontinence, see the category Urinary incontinence repair device.]   Morcellator (C1782)  - Used for cutting, coring, and extracting tissue in laparoscopic procedures. These are distinct from biopsy devices because morcellators are used for t he laparoscopic removal of tissue.   Pacemaker, other than single or dual chamber (C2621)  - Includes cardiac resynchronization devices as well as other pacemakers that are neither single or dual chamber.   Patient programmer (C1787) -  Programmer that allows the patient to operate their neurostimulator, for example, programming the amplitude and rate of stimulation of a neurostimulator system. Only a non- console patient programmer is eligible for transitional pass- through payments.   Peel-away introducer/sheat h (C1892) -  A non- absorbable sheath or introducer that separates into two pieces. This device is used primarily when removal of the sheath is required after a catheter or lead is in the desired position.   Retinal tamponade device, silicone oil (C1814)   A device used as a permanent/prolonged retinal tamponade in the treatment of complex retinal detachments. This is used as a post -operative retinal tamponade following vitreoretinal surgery.