mlsimino

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Does anyone have any information on HCPCS II C9793? I am specifically looking for documentation requirements. For Category I codes we have the AMA Vignette, but for this code, there isn't anything. the only information available is from CMS (see below) and CPT Assist for new HCPCS II codes Jan. 1, 2024.

C9793: 3D predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography with report

CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 12421 Date: December 21, 2023 Change Request 13488

New HCPCS Code Describing 3D Predictive Model Generation for Pre-Planning of a Cardiac Procedure CMS is establishing a new HCPCS code, C9793, to describe 3D predictive model generation for preplanning of a cardiac procedure.

Table 9, attachment A, lists the official long descriptor, status indicator, and APC assignment for HCPCS code C9793. For information on OPPS status indicators, please refer to OPPS Addendum D1 of the CY 2024 OPPS/ASC final rule for the latest definitions.

This code, along with its short descriptor, status indicator, and payment rate, is also listed in the January 2024 update of the OPPS Addendum B.

Effective Date and Payment Information:

Effective Date: January 1, 2024

OPPS APC Status Indicator: S Significant Procedure or Service, Not Discounted when Multiple. Paid under OPPS; Separate APC payment.
 
Does anyone have any information on HCPCS II C9793? I am specifically looking for documentation requirements. For Category I codes we have the AMA Vignette, but for this code, there isn't anything. the only information available is from CMS (see below) and CPT Assist for new HCPCS II codes Jan. 1, 2024.

C9793: 3D predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography with report

CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) Transmittal 12421 Date: December 21, 2023 Change Request 13488

New HCPCS Code Describing 3D Predictive Model Generation for Pre-Planning of a Cardiac Procedure CMS is establishing a new HCPCS code, C9793, to describe 3D predictive model generation for preplanning of a cardiac procedure.

Table 9, attachment A, lists the official long descriptor, status indicator, and APC assignment for HCPCS code C9793. For information on OPPS status indicators, please refer to OPPS Addendum D1 of the CY 2024 OPPS/ASC final rule for the latest definitions.

This code, along with its short descriptor, status indicator, and payment rate, is also listed in the January 2024 update of the OPPS Addendum B.

Effective Date and Payment Information:

Effective Date: January 1, 2024

OPPS APC Status Indicator: S Significant Procedure or Service, Not Discounted when Multiple. Paid under OPPS; Separate APC payment.
Hello Mlsimmo
I d use CPT code 75574 if contrast used add HCPCS A9552 and proper cardiac dx code .Also if this has been done before on the patient years or months ago add modifier PS and if initial or new CT scan on heart use modifier PI. Also add referring physician who gave the order and of course radiologist who read the results.
I hope helped you
Lady T
 
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