HCPCS Device Category C-Codes

Transcription

1 Hospitals are required to report the device category C-codes on claims when used in conjunction with procedures billed and paid under the Medicare hospital outpatient prospective payment system (OPPS) in order to improve the claims data used annually to update the OPPS payment rates. Procedure-to-device code edits look at the procedure code billed and return the claim if the dominant device required to perform the service is not also billed on the same claim. Device-to-procedure code edits look at the device code billed and return the claim if a procedure in which the device is used is not also billed on the same claim. These edits can be found at: REVENUE CODES AND HCPCS CODES Level II HCPCS codes, including C codes, are not applicable to Valve and Vascular products utilized for in-patient procedures such as valve replacement. C codes are used in conjunction with the Medicare prospective payment system for outpatient procedures only. Revenue codes help hospitals categorize services provided by revenue center. Medicare utilizes revenue codes for cost reporting purposes. For Medicare, revenue codes must be included for each service on a CMS 1450 (UB-04) claim form. It may be appropriate for hospitals to capture the cost of products used for the procedures described above within Revenue Code 0278 (Medical/Surgical Supply Other Implant) or Revenue Code 0360 (Operating Room Services - General). Health Care Common Procedural Coding System (HCPCS) codes include level I codes (CPT, described above) and level II codes (other products, supplies, and services not included in CPT). Cardiac Rhythm Management Devices C-Code Device Model Adapter/extension, pacing lead or neurostimulator (implantable) C1883 Pacemaker Adapters , , , , , 2XBIS/BIS-17, BVS/VS-15, BLV/BIS-10 Cardioverter-defibrillator, dual-chamber (implantable) C1721 Atlas DR V-240, V-242 C1721 Epic DR V-233, V-235 C1721 Epic+ DR V-236, V-239 C1721 Atlas+ DR V-243 C1721 Atlas II DR V-265 C1721 Atlas II+ DR V-268 C1721 Epic II DR V-255 C1721 Epic II+ DR V-258 C1721 Current DR , C1721 Current DR RF , C1721 Current Plus DR CD , CD Q C1721 Current Accel DR CD , CD Q C1721 Fortify DR CD , CD Q C1721 Ellipse DR CD , CD Q,CD C, CD ,CD Q, CD , CD Q C1721 Fortify Assura DR CD , CD Q,CD C, CD ,CD Q Cardioverter-defibrillator, single chamber (implantable) C1722 Atlas VR V-199 C1722 Angstrom MD V-190HV3 C1722 Epic VR V-197 C1722 Atlas+VR V-193, V-193C C1722 Atlas II VR V-168 St. Jude Medical, Inc. HCPCS Device Category C- Codes 1

2 C-Code Device Model C1722 Epic+ VR V-196 C1722 Epic II VR V-158 C1722 Convert V-191 C1722 Convert+ V-195 C1722 Current VR , C1722 Current VR RF , C1722 Current Plus VR CD , CD Q C1722 Current Accel VR CD , CD Q C1722 Fortify VR CD , CD Q C1722 Fortify Assura VR CD , CD Q,CD C, CD ,CD Q C1722 Ellipse VR CD , CD Q,CD C, CD ,CD Q Cardioverter-defibrillator, other than single or dual chamber (implantable) C1882 Epic HF V-337, V-338 C1882 Atlas+ HF V-340, V-343 C1882 Atlas II HF V-365 C1882 Epic II HF V-355 C1882 Atlas II+ HF V-366 C1882 Promote , C1882 Promote RF , C1882 Promote Plus CD , CD Q C1882 Promote Accel CRT CD , CD Q C1882 Unify CRT CD , CD Q C1882 Unify Quadra CRT CD , CD Q C1882 Unify Assura CRT CD , CD Q,CD C, CD , CD Q C1882 Quadra Assura CRT CD , CD Q,CD C, CD , CD Q Introducer/sheath, guiding, intracardiac electrophysiological, fixed curve, peel-away C1892 Peel-Away , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1892 SafeSheath HLS-1005, HLS-1006, HLS-1007, HLS-1008, HLS , HLS-1009, HLS , HLS-1010, HLS , HLS-1011, HLS-1012, HLS , HLS-2507, HLS-2508, HLS- 2509, HLS-2510, HLS , HLS-2511 C1892 SafeSheath CSG CSG-90-09/5, CSG-KR-90-09/5, CSG/MSP-00-09/5, CSG/Worley-1-09/5, CSG/Worley-2-09/5 C1892 SafeSheath CSG Braided Core Series CSG/Worley/BCor/1-09, CSG/Worley/L/BCor/1-09, CSG/Worley/BCor/2-09, CSG/BCor-90-09, CSG/KR/BCor C1892 CPS Direct PL , , , , , , , , , , , , , , , N/A* Apeel CS Catheter Delivery System , , , , , , , , , St. Jude Medical, Inc. HCPCS Device Category C- Codes 2

3 C-Code Device Model N/A* N/A* N/A* Apeel CS Plus Catheter Delivery System Alliance Catheter Delivery System SealAway CS Catheter Delivery System , , , , , , * Generally, C-codes have not been established for kits. However, if the kit contains individual items that are identified by C-codes, these items may be billed separately using applicable C-codes. The above Catheter Delivery Systems contain two components with C-codes: the Guiding Peel Away Introducer (C1892) and the guide wire (C1769). Introducer/sheath, guiding, intracardiac electrophysiological, fixed curve, other than peel-away C1893 SafeSheath CSG Braided Series CSG/Worley/B-1-09, CSG/Worley/B-1-07, CSG/Worley/B/L-1-09, CSG/Worley/B/L-1-07, CSG/Worley/B-2-09, CSG/Worley/B-2-07, CSG/B-90-09, CSG/MS/B-00-09, CSG/MS/B C1893 SafeSheath LVI LVI/Tele/B MP, LVI/Tele/B HS, LVI/Tele/B RE, LVI/Tele/B ST C1893 CPS Direct SL , , , , , , , , , , , , , C1893 CPS Direct SL II DS2C001, DS2C002, DS2C003, DS2C004, DS2C005, DS2C006, DS2C011, DS2C012, DS2C013, DS2C014, DS2C015, DS2C018, DS2C019, DS2C020, DS2C021, DS2C022, DS2C023, DS2C025, DS2C026, DS2C027, DS2C028, DS2C029 Lead, cardioverter-defibrillator, endocardial dual coil (implantable) C1895 SPL SP01/70, SP02/70, SP04/100 C1895 Riata ST 7050/60, 7050/65, 7050/75, 7051/60, 7051/65, 7051/75 C1895 Riata ST Optim 7020/60, 7020/65, 7020/75, 7021/60, 7021/65, 7021/75, 7030/60, 7030/65, 7030/75, 7031/60, 7031/65, 7031/75, 7070/60, 7070/65, 7070/75, 7071/60, 7071/65, 7071/75 C1895 Riata SPC 1940/60, 1940/65, 1941/65, 1941/75 C1895 Durata 7120/60, 7120/ /60, 7121/65, 7121/75, 7130/60, 7130/65, 7131/60, 7131/65, 7170/60, 7170/65, 7170/ /60, , 7171/75 C1895 Durata SJ4 7120Q/52, 7120Q/58, 7120Q/65, 7121Q/52, 7121Q/58, 7121Q/65, 7170Q/52, 7170Q/58, 7170Q/65, 7171Q/52, 7171Q/58, 7171Q/65 Lead, cardioverter-defibrillator, endocardial single coil (implantable) C1777 TVL RV06/67, RV07/70, SV01/100, SV02/45, SV03/55, C1777 TVL-ADX 1559/65 C1777 Riata ST 7012/60, 7012/65, 7012/75, 7052/60, 7052/65, 7052/75 C1777 Riata ST Optim 7022/60, 7022/65, 7022/75 C1777 Riata SPC 1942/65 C1777 Durata 7122/60, 7122/65 C1777 Durata SJ4 7122Q/52, 7122Q/58, 7122Q/65, 7172Q/52, 7172Q/58, 7172Q/65 Lead, cardioverter-defibrillator, other than endocardial single or dual coil (implantable) C1896 DP DP/3238 C-Code Device Model Lead, left ventricular coronary venous system C1900 QuickSite 1056K/75, 1056K/86, 1056T/75, 1056T/86 C1900 QuickSite XL 1058T/75, 1058T/86 St. Jude Medical, Inc. HCPCS Device Category C- Codes 3

4 C-Code Device Model C1900 Aescula 1055K/75 C1900 QuickFlex 1156T/75, 1156T/86, 1158T/75, 1158T/86 C1900 QuickFlex Micro 1258T/75, 1258T/86, 1258T/92 C1900 Quartet 1458Q/75, 1458Q/86, 1458Q/92 Lead, pacemaker, other than transvenous VDD single pass C1898 IsoFlex-S 1642T/40, 1642T/46, 1642T/52, 1643K/40, 1643K/46, 1643K/52, 1645K/34, 1645K/40, 1645K/46, 1645K/52, 1645K/58, 1645K/85, 1646T/34, 1646T/40, 1646T/46, 1646T/52, 1646T/58, 1646T/85 C1898 IsoFlex-P 1644T/34, 1644T/40, 1644T/46, 1644T/52, 1648T/34, 1648T/40, 1648T/46, 1648T/52, 1648T/58, 1648T/85 C1898 IsoFlex Optim 1944/46, 1944/52, 1948/46, 1948/52, 1948/58 C1898 Passive Plus DX 1336T/52, 1336T/58, 1342T/46, 1342T/52, 1343K/46, 1343K/52, 1345K/52, 1345K/58, 1346T/52, 1346T/58 C1898 Tendril SDX 1688T/34, 1688T/40, 1688T/46, 1688T/52, 1688T/58, 1688T/85, 1688TC/34, 1688TC/40, 1688TC/46, 1688TC/52, 1688TC/58, 1688TC/85 C1898 Tendril SDX 1488K/46, 1488K/52, 1488K/58, 1488K/85, 1488T/46, 1488T/52, 1488T/58, 1488T/85, 1488TC/46, 1488TC/52, 1488TC/58 C1898 Tendril DX 1388K/46, 1388K/52, 1388K/58, 1388T/100, 1388T/46, 1388T/52, 1388T/58, 1388T/85, 1388TC/46, 1388TC/52, 1388TC/58 C1898 Tendril ST 1782TC/40, 1782TC/46, 1782TC/52, 1788TC/40, 1788TC/46, 1788TC/52, 1788TC/58,1788TC/65, 1788T/40, 1788T/46, 1788T/52, 1788T/65 C1898 Tendril ST Optim 1888TC/40, 1888TC/46, 1888TC/52, 1888TC/58, 1882TC/40, 1882TC46, 1882TC/52 C1898 Tendril STS 2088TC/40, 2088TC/46, 2088TC/52, 2088TC/58 C1898 Myocardial, Active Fixation 1043K/35, 1043K/54, , C1898 Oscor RZ 70 TU, RZ 70 TUV C1898 OptiSense 1699TC/40, 1699TC/46, 1699TC/52, 1999TC/40, 1999TC/46, 1999TC/52 Lead, pacemaker, transvenous VDD single pass C1779 AV Plus DX 1368/52, 1368/58, 1368/65 Pacemaker, dual chamber, non rate-responsive (implantable) C2619 Identity ADx XL DC 5286 C2619 Verity ADx XL DC 5256 C2619 Affinity DC 5230, 5230R C2619 Entity DC 5226, 5226R C2619 Paragon III 2314L, 2315M/S C2619 Tempo D 2902 C2619 Trilogy DC+Trilogy DC+ 2318L C-Code Device Model Pacemaker, dual chamber, rate-responsive (implantable) C1785 Identity ADx DR 5380 C1785 Identity ADx XL DR 5386 C1785 Identity ADx VDR 5480 C1785 Integrity ADx DR 5360 C1785 Integrity ADx XL DR 5366 C1785 Verity ADx XL DR 5356 C1785 Verity ADx XL MS DR 5357 St. Jude Medical, Inc. HCPCS Device Category C- Codes 4

5 C-Code Device Model C1785 Verity ADx XL VDR 5456 C1785 Identity DR 5370 C1785 Identity XL DR 5376 C1785 Integrity µ DR 5336 C1785 Integrity DR 5342/5346 C1785 AddVent 2060BL C1785 Affinity DR 5330, 5330L, 5330R, 5331M/S C1785 Affinity VDR 5430 C1785 Entity DR 5326, 5326L, 5326R C1785 Synchrony III 2028L, 2029M/S C1785 Tempo DR 2102 C1785 Trilogy DR+ 2360L, 2364L, /DAO C1785 Victory XL DR 5816 C1785 Victory DR 5810 C1785 Zephyr DR 5820 C1785 Zephyr XL DR 5826 C1785 Accent DR RF PM2210 C1785 Accent DR PM2110 C1785 Assurity DR RF PM2240 C1785 Endurity DR - inductive PM2160 Pacemaker, other than single or dual chamber (implantable) C2621 Frontier 3x C2621 Frontier II 5586 C2621 Anthem RF PM3210 C2621 Allure Quadra, Allure RF PM3242, PM3222 Pacemaker, single chamber, non rate-responsive (implantable) C2620 Regency SC+ 2402L C2620 Verity ADx XLSC 5056 C2620 Tempo V 1902 Pacemaker, single chamber, rate-responsive (implantable) C1786 Victory SR 5610 C1786 Identity ADx XL SR 5180 C1786 Integrity ADx XL SR 5160 C1786 Verity ADx XL SR 5156 C1786 Verity ADx XL MS SR 5157 C1786 Affinity SR 5130, 5130L, 5131M/S, 5130R C1786 Identity SR 5172 C1786 Integrity SR 5142 C1786 Integrity Micro SR 5136 C1786 Microny II SR+ 2525T C1786 Microny K SR 2535K C1786 Microny SR+ 2425T C1786 Solus II 2006L, 2007M/S C1786 Tempo VR 1102 C1786 Trilogy SR+ 2260L, 2264L C1786 Zephyr SR 5620 C1786 Zephyr XL SR 5626 C1786 Accent SR RF PM1210 C1786 Accent SR PM1110 St. Jude Medical, Inc. HCPCS Device Category C- Codes 5

6 C-Code Device Model C1786 Assurity SR RF PM1240 C1786 Endurity SR inductive PM1160 Event recorder, cardiac (implantable) C1764 Confirm DM 2100 Cardiology and Vascular Access Devices C- Code Device Model Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser C1894 Maximum , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1894 Fast Cath , , , , , ,406168, , , , , ,406530, , , , , ,406204, , , , , ,406216, , , , , ,406119, , , , , ,406101, , , , , , , , , , , ,406107, , , , , ,406133, , , , , ,406136, , , , , ,406580, , , , , ,406704, , , , , ,406541, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,406192, , , , , , , , , , , , , , , , , , , , , , , , Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser C1894 Fast Cath (continued) , , , , , , , , , , , , , , , , , , , , , , , , C1894 Ultimum , , , , , ,407836, , , , , ,407842, , , , , ,407848, , , , , ,407854, , , , , ,407860, , , , , , , , , , , C1894 Engage C408500, C408501, C408502, C408503, C408504, C408505, C408506, C408507, C408508, C408509, C408510, C408511, C408512, C408513, C408514, C408515, C408516, C408517, C408518, C408519, C408520, C C1894 Engage TR C408525, C408526, C408527, C408528, C408529, C408530, C408534, C408535, C408536, C408536, C408537, C408538, C408539, C408540, C408541, C408542, C408543, C408544, C St. Jude Medical, Inc. HCPCS Device Category C- Codes 6

7 C- Code Device Model Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away C1893 Swartz SR , , , , , , , , , , , , , , , , , , , , , C1893 Swartz SL Transseptal , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1893 Swartz Reduced Radius SRR , C1893 Swartz Reduced Radius SLR , Transseptal C1893 Swartz LAMP Transseptal , , , , , , , , , , , C1893 SAFL Fast Cath , C1893 CSTA Fast Cath , C1893 SEPT Fast Cath , C1893 RAMP Fast Cath , , , C1893 Fast-Cath Duo , C1893 Fast Cath , , , , , , , , , , NA* ACross Transseptal Access System with Swartz SL , C- Code Device Model Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away NA* ACross Transseptal Access System with Swartz LAMP , , , *Generally, C-codes have not been established for kits. However, if the kit contains individual items that are identified by C-codes, these items may be billed separately using applicable C-codes. The ACross Transseptal Access System kits contain two components with C- codes: The Guiding Swartz SL or LAMP Sheath (C1893) and the guidewire (C1769). Introducer/sheath, guiding, intracardiac electrophysiological, steerable, other than peel-away C1766 Fast-Cath Two Piece , , C1766 Agilis Introducer , , , , , , G408318, G408319, G408320, G NA* Epicardial Catheter System G *Generally, C-codes have not been established for kits. However, if the kit contains individual items that are identified by C-codes, these items may be billed separately using applicable C-codes. The Epicardial Catheter System kits contain two components with C-codes: The Agilis EPI Steerable Introducer (C1766) and the Response Catheter (C1730). Catheter, guiding (may include infusion/perfusion capability) C1887 Venture Catheter , C1887 CPS Aim , , , , , , , C1887 CPS Luminary , C1887 CPS Aim SL DS2N021/59, DS2N021/65, DS2N022/59, DS2N022/65, DS2N023/59, DS2N023/65, DS2N024/65, DS2N025/65, DS2N026-59, DS2N026-65, DS2N027-59, DS2N DS2N028-59, DS2N028-65, DS2N029-65, DS2N St. Jude Medical, Inc. HCPCS Device Category C- Codes 7

8 C- Code Device Model C1887 CPS Venture Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) Coronary Sinus Balloon C1725 BVCS 6180 Venography Catheter Guide wire C1769 GuideRight , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1769 Floppy Lite Guidewire 4073-LTE-185,4073-LTE-300,4074-LTEJ-185,4074-LTE-J-300 C1769 Floppy Standard Guidewire 4075-STD-185, 4075-STD-300, 4076-STDJ-185, STDJ-300 Guide wire C1769 Floppy Firm Guidewire 4078G, 4078G-FRM-300 C1769 Hydrosteer , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1769 TigerWire C405084, C405085, C405086, C405087, C405088, C C1769 CPS Duo DS2M005, DS2M006, DS2M007 C1769 CPS Courier DS2G001, DS2G002, DS2G003, DS2G004 C1769 PressureWire 12006,12306,12056,12356 C1769 AMPLATZER Guidewire 9-GW-001, 9-GW-002, 9-GW-003, 9GW-004 Closure device, vascular (implantable/insertable) C1760 Angio-Seal 6F STS Platform C1760 Angio-Seal 8F STS Platform C1760 Angio-Seal 6F STS PLUS C1760 Angio-Seal 8F STS Plus C1760 Angio-Seal 6F VIP C1760 Angio-Seal 8F VIP C1760 Angio-Seal 6F Evolution C C1760 Angio-Seal 8F Evolution C Embolization protective system C1884 Proxis Retrieval device, insertable C1773 AMPLATZER TorquVue Exchange System 9-EITV09F-45/80, 9-EITV12F-45/80, 9-EITV06F-180/80 9-EITV08F-180/80 St. Jude Medical, Inc. HCPCS Device Category C- Codes 8

9 C- Code Device Model Septal defect implant system, intracardiac C1817 AMPLATZER Muscular VSD Occluder 9-VSD-MUSC-004, 9-VSD-MUSC-006, 9-VSD-MUSC-008, 9-VSD-MUSC-010, 9-VSD-MUSC-012, 9-VSD-MUSC-014, 9-VSD-MUSC-016, 9-VSD-MUSC-018 C1817 AMPLATZER Multi-Fenestrated 9-ASD-MF-018, 9-ASD-MF-025, 9-ASD-MF-030, 9-ASD-MF-035 Septal Occluder Cribriform C1817 AMPLATZER Septal Occluder 9-ASD-004, 9-ASD-005, 9-ASD-006, 9-ASD-007, 9-ASD-008, 9-ASD-009, 9-ASD-010, 9-ASD-011, 9-ASD-012, 9-ASD-013, 9-ASD-014, 9-ASD-015, 9-ASD-016, 9-ASD-017, 9-ASD-018, 9-ASD-019, 9-ASD-020, 9-ASD-022, 9-ASD-024, 9-ASD-026, 9-ASD-028, 9-ASD-030, 9-ASD-032, 9-ASD-034, 9-ASD-036, 9-ASD-038 Electrophysiology Devices C- Code Device Model Catheter, electrophysiology, diagnostic, other than 3D mapping (19 or fewer electrodes) C1730 evaluator , , , C1730 Livewire Cannulator C1730 Reflexion Bi-Directional Decapolar C1730 Response CV C1730 Inquiry Bi-Directional Decapolar Catheter 81503, 81504, 81101, 81102, 81104, 81105, 81107, 81108, 81520, 81524, 81945, C1730 Inquiry 4 Fr. Fixed Catheters 80130, 80131, 80132, 80133, 80134, 80135, 80137, 80138, 80464, 80465, 80466, 80467, 80468, 80469, 80485, 80535, C1730 Inquiry 5 Fr. Fixed Catheters 80051, 80052, 80053, 80054, 80055, 80063, 80064, 80065, 80451, 80452, 80453, 80454, 80455, 80456, 80458, 80459, 80463, 80556, Catheter, electrophysiology, diagnostic, other than 3D mapping (19 or fewer electrodes) C1730 Inquiry 6 Fr. Fixed Catheters 80001, 80002, 80003, 80008, 80010, 80017, 80116, 80404, 80405, 80406, 80407, 80408, 80409, 80410,80411, 80412, 80413, 80414, 80415, 80501, 80508,80601, 80602, 80603, 80604, 80606, 80630, 80801, 80802, 80803, 80804, 80805, 80806, C1730 Livewire , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , C1730 Response , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , St. Jude Medical, Inc. HCPCS Device Category C- Codes 9

10 401310, , , , , , , , , , , , , , , , , , , , , , , , , C1730 Inquiry Soft Tip Fixed Catheters 80139, 80470, 80473, 80476, 80478, 80479, 80484, 80516, 80517, 80518, 80519, 80520, 80533, 80534, 80537, 80544, C1730 Inquiry 4 Fr. Steerable Catheters 81540, 81541, 81542, 81545, 81530, 81531, 81532, 81534, 81535, 81536, 81537, C- Code Device Model C1730 Inquiry 5 Fr. Steerable Catheters 81171, 81172, 81174, 81176, 81177, 81178,81179, 81223, 81224, 81229, 81471, 81472, 81473, 81474, 81475, 81478, 81479, 81871, 81872, 81873, 81874, 81877, 81879, 81886, C1730 Supreme , , , , , , , , , , , ,, , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , Catheter, electrophysiology, diagnostic, other than 3D mapping (19 or fewer electrodes) C1730 C1730 Inquiry 6 Fr. Steerable Catheters Inquiry Soft Tip Steerable Catheters 81101, 81102, 81104, 81105, 81106, 81107, 81108, 81109, 81231, 81401, 81402, 81403, 81404, 81405, 81406, 81407, 81412, 81414, 81415, 81416, 81417, 81418, 81420, 81462, 81511, 81516, 81520, 81524, 81601, 81602, 81603, 81604, 81605, 81801, 81802, 81803, 81807, 81809, 81810, , 81483, 81521, 81703, 81704, 81705, 81706, 81721, 81730, 81731, 81732, 81733, 81734, 81735, 81736, 81737, 81738, 81742, 81743, 81745, 81747, 81750, 81751, 81757, 81758, 81823, 81940, 81943, 81945, 81946, 81947, 81951, 81954, 81956, 81958, C1730 Inquiry H-Curve Catheters 81125, 81110, 81112, 81126, 81129, C1730 Inquiry HIS Fixed and Steerable 80440, 80515, 80567, 80820, 80847, 81169, 81483, 81484, 81485, C1730 Inquiry Luma Catheter, Fixed and Steerable 80901, 80902, 81910, 81911, 81912, 81913, 81914, 81915, 81917, 81918, 81920, 81921, 81922, 81937, 81938, 81939, 81960, C1730 Inquiry A Focus 81591, 81594, 81595, 81596, 81670, 81671, 81672, 81673, 81674, 81676, 81680, 81589, 81597, C1730 Inquiry Optima 81687, Catheter, electrophysiology, diagnostic, other than 3D mapping (20 or more electrodes) C1731 Livewire Steerable, Duo-Deca , , , , , C1731 Reflexion Spiral Variable Radius , D402893, D Mapping Catheter C1731 Reflexion HD Mapping Catheter D C1731 Inquiry H Curve Catheters 81120, 81124, 81128, 81130, 81131, 81134, 81136, C1731 Inquiry A Focus 81587, 81598, C1731 Inquiry Optima 81659, 81683, C1731 Inquiry Optima PLUS C1731 Inquiry 7F Ten-Ten 81202, 81207, 81209, St. Jude Medical, Inc. HCPCS Device Category C- Codes 10

11 C-Code Device Model Catheter, electrophysiology, diagnostic/ablation, 3D or vector mapping C1732 EnSite Array Catheter EC1000 Catheter, electrophysiology, diagnostic/ablation, other than 3D or vector mapping, other than cool tip C1733 Safire TX , , , , , C1733 Livewire TC , , , , , , , , , , , , , , C1733 Safire , , , , , , , , , , , C1733 Therapy Dual , 83371, 83372, 83373, 83374, C1733 Therapy 8mm Tip 83441, 83442, 83444, 83445, C1733 Therapy Bi-Directional 4mm Tip 83719, 83720, C1733 Therapy 4mm Tip 83364, 83365, 83366, 83367, 83368, 83369, 83724, 83725, 83726, Catheter, electrophysiology,diagnostic/ablation, other than 3D or vector mapping, cool tip C2630 Cool Path 83326, 83327, 83328, 83329, 84308, 84309, 84310, 84311, C2630 Safire BLU A402869, A402871, A402870, A C2630 Safire BLU Duo A088106, A088108, A088107, A C2630 Therapy Cool Path A088046, A088047, A088048, A Catheter, intracardiac echocardiography C1759 ViewFlex PLUS , , C1759 ViewFlex XTRA , Neuromodulation C-Code Device Model Generator Neurostimulator (Implantable) Non-rechargeable C1767 Genesis Pulse Generator, 8-Channel 3608 C1767 GenesisXP Pulse Generator, 8-Channel 3609 C1767 Genesis Pulse Generator, Dual 4-Channel 3643 C1767 GenesisXP Pulse Generator, Dual 4-Channel 3644 C1767 EonC 16-Channel IPG 3688 Lead Neurostimulator (Implantable) C1778 Quattrode Lead 3141, 3143, 3146, 3149, 3151, 3153, 3156, 3159, 3161, 3163, 3166, 3169 C1778 Octrode Lead Kit 3181, 3183, 3186, 3189 C1778 Lamitrode Tripole 3208, 3210, 3214, 3219 C1778 Exclaim Lead 3224, 3225 C1778 Penta Lead 3228 C1778 Lamitrode Lead Kit 3240, 3243, 3244, 3245, 3246, 3254, 3255, 3262, 3263, 3264, 3265, 3266, 3267, 3268, 3269, 3280, 3283, 3286, 3288, 3289 C1778 Axxess Quad Lead 4143,4146,4153,4156 Patient Programmer, Neurostimulator C1787 Genesis Programmer 3850 C1787 Eon Patient Programmer 3851 C1787 QuickLink Controller 3860 Generator, Neurostimulator (Implantable, w/rechargeable battery inc. the recharging system) C1820 Eon Rechargeable IPG, Eon Mini 3716, 3788 St. Jude Medical, Inc. HCPCS Device Category C- Codes 11

12 Adapter/Extension, Pacing Lead (Implantable) C1883 CompuStim Adapter 2243, 2283 C1883 A127 Extension 2341, 2342, 2343, 2346 C1883 Extension, Dual 4-Channel 3341, 3342, 3343, 3346 C1883 Extension 3382, 3383, 3386 Lead Neurostimulator Test Kit (Implantable) reinstated by CMS 04/01/06 C1897 Quattrode Trial Lead Kit 3046, 3066, 3086 C1897 Octrode Trial Lead Kit 3086 C1897 Axxess Quad Trial Lead 4044, 4054 Please direct questions on C-codes to: Reimbursement Hotline This document and the information contained herein is for general information purposes only and is not intended and does not constitute legal, reimbursement, coding, business or other advice. Furthermore, it is not intended to increase or maximize payment by any payer. Nothing in this document should be construed as a guarantee by St. Jude Medical regarding levels of reimbursement, payment or charge, or that reimbursement or other payment will be received. Similarly, nothing in this document should be viewed as instructions for selecting any particular code. The ultimate responsibility for coding and obtaining payment/reimbursement remains with the customer. This includes the responsibility for accuracy and veracity of all coding and claims submitted to third party payers. Also note that the information presented herein represents only one of many potential scenarios, based on the assumptions, variables and data presented. In addition, the customer should note that laws, regulations and coverage and coding policies are complex and are updated frequently, and therefore the customer should check with its local carriers or intermediaries often and should consult with legal counsel or a financial, coding or reimbursement specialist for any coding, reimbursement or billing questions or any related issues. St. Jude Medical, Inc. HCPCS Device Category C- Codes 12