Summary & Overview
HCPCS C9776: Intraoperative Near-Infrared Bile Duct Imaging with ICG
HCPCS Level II code C9776 specifies intraoperative near-infrared fluorescence imaging of major extra-hepatic bile ducts using intravenous indocyanine green (ICG) as an imaging adjunct during biliary surgery. This code identifies use of a visualization technique intended to improve anatomic delineation of the cystic duct, common bile duct, and common hepatic duct during operative procedures.
Nationally, recognizing and properly coding intraoperative fluorescence imaging matters for capture of procedural complexity, operative documentation, and device/drug utilization tracking. Key payers commonly referenced in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will gain a concise overview of the clinical context for C9776, expected sites of service, and the role of ICG fluorescence imaging in hepatobiliary operations. The publication also summarizes common payer coverage landscape and coding considerations, provides benchmarking context where available, and highlights policy and billing updates relevant to facilities and surgical teams. Data not available in the input for payer-specific rates, ICD-10 mappings, and associated taxonomies is noted.
Billing Code Overview
HCPCS Level II code C9776 describes intraoperative near-infrared fluorescence imaging of major extra-hepatic bile duct(s) (for example, cystic duct, common bile duct, and common hepatic duct) performed with intravenous administration of indocyanine green (icg).
Service type: Intraoperative imaging adjunct — the procedure is an intraoperative guidance technique used during hepatobiliary surgery to visualize extra-hepatic bile ducts.
Typical site of service: Hospital operating room or ambulatory surgical center where operative biliary procedures are performed.
Data not available in the input for taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific coverage rules.
Clinical & Coding Specifications
Clinical Context
A 52-year-old female undergoes an elective laparoscopic cholecystectomy for symptomatic cholelithiasis with intermittent biliary colic and biochemical evidence of cholestasis. During surgery, the operating surgeon elects to perform intraoperative near-infrared fluorescence imaging of the major extra-hepatic bile ducts using intravenous indocyanine green (ICG) to better visualize the cystic duct, common hepatic duct, and common bile duct and to reduce risk of bile duct injury. The clinical workflow includes preoperative consent and screening for iodine/ICG allergy, intravenous administration of indocyanine green approximately 15–30 minutes prior to imaging (timing per institutional protocol), setup of near-infrared fluorescence imaging system in the operating room, acquisition of fluorescence images during dissection of the Calot triangle, documentation of findings in the operative note, and billing the imaging service separately in addition to the primary surgical procedure using C9776 as an add-on HCPCS Level II code. Typical site of service is the operating room or ambulatory surgery center during a minimally invasive or open biliary surgery. Common clinical indications include cholelithiasis, acute or chronic cholecystitis, suspected choledocholithiasis, or biliary anatomy clarification in patients with prior hepatobiliary surgery or atypical anatomy.
Coding Specifications
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