Summary & Overview
HCPCS C7571: Coronary Angioplasty with Lithotripsy
HCPCS Level II code C7571 represents percutaneous transluminal coronary angioplasty of a single major coronary artery or branch performed with percutaneous transluminal coronary lithotripsy. The code captures a specialized catheter-based intervention used to treat obstructive, calcified coronary lesions by combining balloon angioplasty with intraluminal lithotripsy to fracture calcium and facilitate vessel expansion. Nationally, this code is relevant as coronary lithotripsy becomes more widely adopted for complex percutaneous coronary interventions and for tracking utilization and coverage of advanced endovascular tools.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context of the procedure, typical sites of service, and which payers are commonly relevant for coverage and claims. Where available, the publication summarizes reimbursement benchmarks, payer policy themes, and coding considerations tied to the procedure's clinical indications. The report also provides links between the intervention and common procedural workflows in cardiac catheterization laboratories, and highlights areas where payers may issue specific medical necessity or coverage criteria for calcified coronary disease management.
Data not available in the input on modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific rates.
Billing Code Overview
HCPCS Level II code C7571 describes percutaneous transluminal coronary angioplasty of a single major coronary artery or branch performed with percutaneous transluminal coronary lithotripsy. This procedure involves catheter-based dilation of a coronary artery to restore blood flow in the presence of obstructive calcified plaque, with lithotripsy used to fracture calcified lesions prior to or during balloon angioplasty.
Service type: Coronary percutaneous transluminal angioplasty with lithotripsy
Typical site of service: Hospital inpatient or hospital outpatient cardiac catheterization laboratory
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with a history of chronic, calcific coronary artery disease and progressive exertional angina is referred for percutaneous management after noninvasive testing and diagnostic coronary angiography demonstrate a severely stenotic, heavily calcified lesion in the proximal left anterior descending artery. The interventional cardiology team schedules a percutaneous transluminal coronary angioplasty with intravascular lithotripsy to modify the calcium and facilitate safe balloon dilatation and stent delivery. The patient presents to the cardiac catheterization laboratory fasting; informed consent and pre-procedure medication reconciliation are completed. Vascular access is obtained (commonly via the right radial or femoral artery), baseline hemodynamics and selective coronary angiography are performed to confirm lesion morphology, then intravascular lithotripsy catheter is positioned across the calcified segment, pulses of acoustic energy are delivered to fracture calcium, followed by balloon angioplasty and drug-eluting stent deployment. Peri-procedural care includes anticoagulation management, hemodynamic monitoring, access site hemostasis, and post-procedure observation in a recovery or telemetry unit prior to discharge on dual antiplatelet therapy as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when reporting only the physician interpretation or professional portion separate from technical facility charges. |