Summary & Overview
HCPCS C1761: Coronary Intravascular Lithotripsy Catheter
HCPCS Level II code C1761 designates a catheter used for transluminal intravascular lithotripsy in coronary interventions. The code identifies a specialized device intended to fracture vascular calcium within coronary arteries to facilitate dilation and stent deployment. Nationally, the adoption of intravascular lithotripsy has implications for procedural planning, device utilization tracking, and hospital outpatient reimbursement workflows.
Key payers in the national context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication summarizes how C1761 is used in clinical care, the typical sites of service where the device is employed, and the billing and coding considerations payers commonly assess.
Readers will find benchmarks and context about device use and coding, summaries of payer coverage trends, and clinical background relevant to interventional cardiology teams and billing professionals. The report highlights where C1761 fits within procedure documentation and service lines, notes common modifiers encountered in practice, and identifies areas where policy updates or payer guidance may affect billing and coverage. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1761 represents a catheter used for transluminal intravascular lithotripsy in coronary procedures. This device is used to deliver lithotripsy energy intravascularly to treat calcified coronary lesions that impede balloon dilation or stent delivery.
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Service type: Coronary intravascular lithotripsy device delivery
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Typical site of service: Hospital outpatient departments and catheterization laboratories (inpatient cardiac catheterization labs may also be involved)
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Clinical & Coding Specifications
Clinical Context
A 72-year-old male with known multivessel coronary artery disease and recurrent exertional angina despite optimal medical therapy presents after diagnostic coronary angiography showing severe, heavily calcified stenosis of the proximal left anterior descending artery (LAD). The interventional cardiology team schedules an intravascular lithotripsy (IVL) procedure using a coronary-specific IVL catheter to modify calcium before stent implantation. The patient arrives to the cardiac catheterization laboratory; vascular access is obtained (commonly radial or femoral), anticoagulation is administered, and a guiding catheter and guidewire are positioned across the lesion. The C1761 device (catheter, transluminal intravascular lithotripsy, coronary) is advanced to the target site. Pulsed acoustic pressure waves are delivered to fracture intimal and medial calcium, facilitating balloon angioplasty and drug-eluting stent deployment. Post-procedure angiography confirms satisfactory stent expansion and TIMI-3 flow. Recovery occurs in the post-anesthesia care or cardiac observation area; discharge planning and secondary prevention medications are reviewed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity substantially exceeds normal for IVL (document rationale and supply use). |