Summary & Overview
HCPCS C9755: Percutaneous Magnetic-Guided Arteriovenous Fistula Creation
HCPCS Level II code C9755 designates the percutaneous creation of an arteriovenous fistula using magnetic-guided arterial and venous catheters and radiofrequency energy, including associated flow-directing procedures and imaging studies with radiologic supervision and interpretation when performed. This code captures a novel, image-guided endovascular approach to AV access creation that can impact vascular access management for patients requiring hemodialysis.
Key national payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis outlines payer coverage considerations, coding and billing context, and where C9755 fits within endovascular and interventional radiology service lines.
Readers will gain a concise clinical and billing overview of the service represented by C9755, understand typical sites of service and procedure components, and see what to expect in terms of claims context and policy relevance. The publication provides benchmarks and policy update summaries where available, clinical context around percutaneous AV fistula creation techniques, and guidance on documentation elements that support use of HCPCS Level II code C9755. Data not available in the input is identified as such in the detailed sections.
Billing Code Overview
HCPCS Level II code C9755 describes the creation of an arteriovenous fistula by percutaneous technique using magnetic-guided arterial and venous catheters with radiofrequency energy. The procedure includes flow-directing procedures (for example, vascular coil embolization with radiologic supervision and interpretation, when performed) and may include fistulogram(s), angiography, venography, and/or ultrasound with radiologic supervision and interpretation, when performed.
Service type: Image-guided percutaneous vascular access and endovascular fistula creation.
Typical site of service: Hospital outpatient interventional radiology suite or ambulatory surgery center with imaging support, where interventional radiology or vascular specialists perform percutaneous vascular procedures with fluoroscopy, ultrasound, and radiologic supervision and interpretation.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old with end-stage renal disease on hemodialysis via tunneled catheter who requires durable vascular access. The patient has suitable upper arm arterial and venous anatomy on preprocedural imaging but is not a candidate for open surgical fistula creation due to comorbidities (e.g., congestive heart failure, diabetes) or prior failed surgical attempts. Interventional radiology schedules a percutaneous arteriovenous fistula creation procedure using magnetic-guided arterial and venous catheters and radiofrequency energy. The workflow includes preprocedure duplex ultrasound and cross-sectional venous mapping, informed consent, intravenous sedation or monitored anesthesia care, ultrasound and fluoroscopic guidance for arterial and venous access, magnetic catheter alignment across the target arterial and venous segments, application of radiofrequency energy to create the arteriovenous anastomosis, completion fistulogram(s) and angiography to assess flow, and any adjunctive flow-directing procedures such as coil embolization of collateral veins if needed. Postprocedure care includes ultrasound assessment of fistula flow, hemostasis, short observation for access-site complications, and coordination with the dialysis center for future cannulation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional Component | Use when reporting only the physician interpretation portion of imaging performed with the procedure if the facility bills technical component separately. |