HCPCS code C7542 — Ercp w/bx & pancreatoscopy.
Status: Active.
Effective Jan 1, 2024.
Source: CMS HCPCS Level II.
C7542
ActiveErcp w/bx & pancreatoscopy
Endoscopic retrograde cholangiopancreatography (ercp) with biopsy, single or multiple, with endoscopic cannulation of papilla with direct visualization of pancreatic/common bile ducts(s)
Category:
Outpatient PPS
Section:
C-codes: Outpatient PPS
Effective:
Jan 1, 2024
Code type:
alphanumeric
OPPS Status:
E1
— Items / services not paid by Medicare
MUE — Medically Unlikely Edits
Maximum units of C7542 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| Outpatient Hospital | 1 |
| Practitioner Services | 1 |
Source: CMS Medicare NCCI Medically Unlikely Edits
Change History
Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.
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New Code 2024-Q1Ercp w/bx & pancreatoscopy