Libman Education is proud to offer ZHealth Publishing’s broad range of coding products to assist both the novice and the seasoned coder to become experts at coding and charging for complex procedures in Interventional Radiology, Interventional Cardiology, Vascular/Endovascular Surgery, and Diagnostic Radiology. Periodically, ZHealth Publishing experts offer general recommendations in response to specific customer inquiries.
by David Zielske, MD, CIRCC, COC, CCVTC, CCC, CCS, RCC
Question: C9754 & C9755 HCPCS 2019
For 2019, two new HCPCS came out that represent Percutaneous Fistula Creation (Ellipsys). However, there is no information available as to whether the two new codes can be billed together (IN hospital OPPS or ASC Facility as it meets the Pass Through). Do you happen to know any extra information about these two new codes and how they are to be used?
Two innovative developments for dialysis patients became available this year for percutaneous creation of an AV fistula for use in dialysis. Both the Ellipsys Vascular Access System and the everlinQ Vascular Access System received FDA approval in June 2018. A HCPCS II code becomes available January 1, 2019 for each of these with C9754 and C9755 respectively.
The Ellipsys utilizes a single venous access with puncture of the artery via this access to create the AV communication, then, using the device and RF fusion technique the fistula is permanent between the artery and vein. This is considered a “direct” percutaneous approach and is reported with C9754. The everlinQ requires a percutaneous venous and a separate percutaneous arterial access, use of two catheters with a built in magnet to position the catheters, then using RF energy to create the fistula and is reported with C9755.
Both procedures are performed percutaneously, include any ultrasound guidance for vascular access, all arterial and venous angiography, radiologic S & I, angioplasty of involved vessels, and embolization of any branches (which are normally clipped at the time of open surgical creation). These procedures are described by the single codes listed above.
Comprehensive and In-depth Webinars, eLearning and Course Packages. Libman Education is proud to partner with ZHealth Publishing to provide training of coders for interventional radiology, cardiology, and vascular surgery, and other complex medical specialties involving minimally invasive image-guided diagnosis and treatment of diseases in every organ system. Learn more here.