HCPCS code C9797 — Vasc emb/occ w/prs cath. Status: Active. Effective Jan 1, 2024. Source: CMS HCPCS Level II.

C9797

Active

Vasc emb/occ w/prs cath

Vascular embolization or occlusion procedure with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; for tumors, organ ischemia, or infarction

Category: Outpatient PPS
Section: C-codes: Outpatient PPS
Effective: Jan 1, 2024
Code type: alphanumeric
OPPS Status: J1 — Hospital Part B services paid through a comprehensive APC (C-APC)
OPPS APC: 5194

MUE — Medically Unlikely Edits

Maximum units of C9797 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

NCCI Edits

The following codes cannot be billed together with C9797 without appropriate documentation.

Column 2 Code Modifier
G0181 Modifier cannot bypass edit
G0182 Modifier cannot bypass edit
G0463 Modifier may bypass edit
G0471 Modifier may bypass edit
J0670 Modifier may bypass edit
J1642 Modifier may bypass edit
J1644 Modifier may bypass edit

Source: CMS National Correct Coding Initiative (NCCI)

Change History

Quarterly changes published by CMS. Revisions may affect the code description, coverage, or rate — review each quarter's changes before submitting claims.

  • New Code 2024-Q1
    Vasc emb/occ w/prs cath