(Medicare Claims Processing Manual)

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 used 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 designated 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 temperatur e 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 in 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 peripheral 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 measu ring 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 i n a two -stage surgical 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 functions 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 via 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 silicone 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 tissue defects, etc. [For reporting connective tissue (human or non- human) when used to trea t urinary incontinence, see the category Connective tissue, human or Connective tissue, non- human.] [For reporting urinary incontinence repair device when used to treat urinary incontinence, see the category Urinary incontinence repair dev ice.]   Morcellator (C1782)  - Used for cutting, coring, and extracting tissue in laparoscopic procedures. These are distinct from biopsy devices because morcellators are used for the 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/sheath (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.   Retrieval device, insertable (C1773)  - A device designed to retrieve other devices or portions thereof (e.g., fractured catheters, leads) lodged within the vascular system. This can also be used to retrieve fractured medical devices or to exchange introducers/sheaths.   Septal defect implant system (C1817) - An intracardiac metallic implant used for closure of various septal defects within the heart. The septal defect implant system includes a delivery catheter. The category code for the septal defect implant system (C1817) includes the delivery catheter; t herefore, the delivery catheter should not be reported separately.   Stents with delivery system (C1874, C1876, C2625) -  Stents packaged with delivery systems generally include the following components: stent mounted or unmounted on a balloon angioplasty catheter, introducer, and sheath. These components should not be reported separately.   Temporary non -coronary stent (C2617, C2625)  - Usually composed of a substance, such as plastic or other non -absorbable material, designed to permit removal. Typically, this type of stent is placed for a period of less than one year.   Tissue marker (C1879)  - A material that is placed in subcutaneous or parenchymal tissue (may also include bone) for radiopaque identification of an anatomic site. These markers are distinct from topical skin markers, which are positioned on the surface of the skin to serve as anatomical landmarks.   Transluminal angioplasty catheter (C1725, C1885) -  Designed to dilate stenotic blood vessels (arteries and veins). For vascular use, the terms balloon dilatation catheter and translumina l angioplasty catheter are frequently used interchangeably. [For the reporting of non- vascular balloon dilatation catheters, see the category "Balloon dilatation catheter" (C1726).]   Transvenous VDD single pass pacemaker lead (C1779) -  A transvenous pacemaker lead that paces and senses in the ventricle and senses in the atrium.   Urinary incontinence repair device (C1771, C2631) -  Used to attach or insert a sling graft for the purpose of strengthening the pelvic floor. It consists of the device components used to deliver (suprapubically or transvaginally) and/or fixate (via permanent sutures or bone anchors) the sling graft. The device may or may not be packaged with a sling graft. Report the appropriate category for a device with or without a sling graft. NOTE: For reporting connective tissue (human or non-  human) when used to trea t urinary incontinence, see the category Connective tissue, human (C1762) or Connective tissue, non- human (C1763). For reporting mesh when used to treat urinary incontinence, see the category Mesh (C1781).   Vascular closure device (implantable /insertable) (C1760)  - Used to achieve hemostasis at arterial puncture sites following invasive or interventional procedures using biologic substances (e.g., collagen) or suture through the tissue tract.   Vector mapping catheter (C1732)  - Refers to an electrophysiology catheter with an "in-plane" orthogonal array of electrodes. This catheter is used to locate the source of a focal arrhythmia.    60.5 - Services Eligible for New Technology APC Assignment and Payments (Rev. 3941; Issued: 12- 22-17; Effective: 01 - 01-18; Implementation: 01 -02-18) Under OPPS, services eligible for payment through New Technology APCs are those codes that are assigned to the series of New Technology APCs published in Addendum A of the latest OPPS update.  As of January 1, 2018, the range of New Technology APCs include     APCs 1491 through 1500  APCs 1502 through 1537  APCs 1539 through 1585  APCs 1589 through 1599, and  APCs 1901 through 1908   OPPS considers any HCPCS code assigned to the above APCs to be a new technology procedure or service.   Application procedures for consideration as a New Technology procedure or service may be found on the CMS Web site, currently at https://www.cms.gov/Medicare/Medicare -Fee-for-Service -Payment/HospitalOutpatientPPS/passthrough_payment.html .  Under the Downloads section, refer to the document titled For a New Technology Ambulatory Payment Classification (APC) Designation under the Hospital Outpatient Prospective Payment System (OPPS) for information on the requirements for submitting an application.  The list of HCPCS codes and payment rates assigned to New Technology APCs can be found in Addendum B of the latest OPPS update regulation each year at  https://www.cms.gov/Medicare/Medicare -Fee-for-Service-Payment/HospitalOutpatientPPS/Addendum -A-and-Addendum -B-Updates.html. Please note that this link may change depending on CMS Web design requirements   61 - Billing for Devices Under the OPPS  (Rev. 1657, Issued: 12- 31-08, Effective: 01 -01-09, Implementation: 01 -05-09)  Future updates will be issued in a Recurring Update Notification.