Summary & Overview
HCPCS C9602: Coronary Atherectomy with Drug‑Eluting Stent and Angioplasty
HCPCS Level II code C9602 represents a combined percutaneous transluminal coronary atherectomy with placement of a drug‑eluting intracoronary stent and coronary angioplasty when performed for a single major coronary artery or branch. Nationally, this code captures a complex, catheter‑based revascularization technique used in coronary artery disease management and is relevant for clinical coding, inpatient procedure tracking, and payer coverage determinations.
Key payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of the clinical procedure and its typical inpatient hospital setting, comparisons to related procedure codes that capture primary and add‑on coronary revascularization services, and a summary of common billing modifiers used with this service. The publication highlights coding relationships to other HCPCS Level II entries for coronary stenting and atherectomy to aid accurate claim reporting. It also summarizes typical ICD‑10 diagnostic contexts associated with the procedure.
The content is intended to inform coding professionals, billing administrators, and clinical leaders about the clinical definition and billing context of C9602, provide clarity on related codes used for multi‑vessel procedures, and identify where input data are missing for full service‑line benchmarking. Data not available in the input.
Billing Code Overview
HCPCS Level II code C9602 describes percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch. This procedure falls under Percutaneous Transcatheter/Transluminal Coronary Procedures and is typically performed in an Inpatient Hospital (POS 21) setting.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical inpatient cardiology patient is an older adult admitted to the hospital with symptoms of acute coronary ischemia (for example chest pain, dyspnea, diaphoresis) and diagnostic evidence of coronary artery obstruction on coronary angiography. After diagnostic angiography identifies a significant lesion in a single major coronary artery or a major branch, the interventional cardiology team performs a percutaneous transluminal coronary atherectomy to debulk a calcified or resistant lesion, followed by placement of a drug‑eluting intracoronary stent and adjunctive coronary angioplasty as needed. The procedure is performed in the cardiac catheterization laboratory under monitored anesthesia or general anesthesia, typically documented in the inpatient hospital setting (POS 21). Preprocedural documentation includes indication (for example unstable angina or acute myocardial infarction), informed consent, medications administered, and clinical risk assessment. Operative note documents vessel treated, devices used (atherectomy device, drug‑eluting stent), angioplasty balloons, complications if any, and access site. Postprocedure notes include hemodynamic stability, access site management, antiplatelet therapy plan, and disposition (observation in telemetry unit or admission to cardiac floor or ICU). Billing is submitted using HCPCS Level II code C9602 for the described single major coronary artery or branch intervention.
Coding Specifications
-
Modifiers
-
26: Professional Component — used when reporting only the physician’s professional work (interpretation, procedure) separate from the facility/technical component. Use when the hospital bills separately for technical component and the physician bills professional services. -
51: Multiple Procedures — used when multiple distinct procedures are reported on the same day by the same provider and payer requirements permit. Apply per payer rules for surgical package reductions.