Summary & Overview
HCPCS Level II C9793: 3D Predictive Model for Cardiac Procedure Pre‑planning
HCPCS Level II code C9793 covers generation of a patient-specific 3D predictive model for pre-planning cardiac procedures using cardiac computed tomographic angiography (CTA) and/or magnetic resonance imaging (MRI) data, accompanied by a report. This code is nationally significant as advanced cardiac planning models increasingly inform complex structural and interventional cardiac procedures, supporting device selection, procedural strategy, and risk assessment.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for 3D predictive cardiac modeling, typical sites of service where the work is performed, and the scope of documentation associated with the service. The publication outlines benchmarks and policy-relevant considerations such as payer coverage trends, coding and reporting implications, and where practice patterns intersect with imaging and procedural workflows. Where available, payers' coverage patterns and reimbursement constructs are summarized to inform administrative and clinical stakeholders.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, and service line details are noted as unavailable.
Billing Code Overview
HCPCS Level II code C9793 describes 3D predictive model generation for pre-planning of a cardiac procedure, using data from cardiac computed tomographic angiography and/or magnetic resonance imaging with report. This service encompasses the creation of a patient-specific three-dimensional predictive model to support procedural pre-planning for cardiac interventions.
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Service type: Image-based 3D predictive model generation for cardiac procedure pre-planning
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Typical site of service: Hospital outpatient setting, ambulatory surgical center, or advanced imaging center where cardiac CTA or cardiac MRI data are acquired and processed
Clinical & Coding Specifications
Clinical Context
A 72-year-old male with symptomatic severe aortic stenosis is evaluated for transcatheter aortic valve replacement (TAVR). The structural heart team orders a cardiac computed tomographic angiography (CCTA) to assess aortic annulus dimensions, coronary ostial heights, valve morphology, and peripheral vascular access. The imaging dataset is sent to a specialized 3D modeling service to generate a patient-specific C9793 3D predictive model for pre-planning. The workflow includes image acquisition (CCTA or cardiac MRI), radiology or cardiology review with a formal report, secure transfer of DICOM data to the modeling vendor, generation of the 3D predictive model and accompanying report, multidisciplinary review by interventional cardiology, cardiac surgery, and imaging specialists, and incorporation of model findings into the procedural plan (valve size selection, delivery approach, and vascular access strategy). Typical sites of service include hospital-based cardiovascular imaging suites, outpatient advanced imaging centers, or integrated structural heart program facilities. The typical patient scenario includes elderly patients with valvular heart disease, congenital or complex cardiac anatomy requiring pre-procedural simulation, or candidates for complex structural interventions such as TAVR, left atrial appendage occlusion, or complex coronary interventions where 3D predictive modeling informs device selection and approach.
Coding Specifications
| Modifier | Description | When to Use |
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