Summary & Overview
HCPCS C1749: Implantable Retrograde Colonoscope Endoscope
HCPCS Level II code C1749 denotes an implantable endoscope device designed for retrograde imaging and illumination of the colon. This device code is relevant for hospitals and facility billing where an implantable colonoscopic imaging device is used for diagnostic visualization or ongoing monitoring. Nationally, the code matters because it identifies a specialized, implantable medical device with implications for facility charges, device supply chains, and payer coverage policy for advanced endoscopic technologies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The coverage landscape for implantable diagnostic devices can vary across commercial plans and Medicare policies, affecting claim adjudication and prior authorization requirements.
Readers will learn the clinical context for C1749, including typical service settings and the nature of the device, plus an overview of what to expect in benchmarking and policy review sections. The publication provides benchmarks where available, summaries of payer policy themes relevant to implantable endoscopic devices, and the clinical scenarios in which this code is typically reported. Data not available in the input will be noted as such in the detailed sections.
Billing Code Overview
HCPCS Level II code C1749 describes an implantable endoscope device used for retrograde imaging and illumination of the colon. The device is characterized as an implanted colonoscope designed to provide internal visualization and light for diagnostic or monitoring purposes.
Service type: Implantable endoscopic device placement/management
Typical site of service: Inpatient hospital or outpatient hospital-based procedural setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of intermittent lower abdominal pain, chronic iron-deficiency anemia, and occult positive fecal immunochemical testing is evaluated for suspected colonic pathology. After noninvasive testing is inconclusive, the gastroenterology team recommends placement of an implantable retrograde imaging/illumination colonoscope device to provide continuous or intermittent retrograde luminal imaging for diagnostic surveillance and to localize intermittent bleeding sources.
Preprocedure workflow: informed consent, review of indications and contraindications, preoperative assessment for anesthesia risk, and scheduling for an outpatient or ambulatory procedure depending on patient comorbidities. The device implantation is performed in a procedure suite or operating room with fluoroscopic support as needed. Postprocedure workflow includes device function check, wound care instructions, pain control, documentation of device model and lot, and scheduling of follow-up imaging interrogation or removal if temporary.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to implant the device is substantially greater than typical due to complexity or extent. |
23 |