Summary & Overview
HCPCS Level II C1722: Single‑Chamber Implantable Cardioverter‑Defibrillator
HCPCS Level II code C1722 designates an implantable single‑chamber cardioverter‑defibrillator (ICD). These devices are critical in preventing sudden cardiac death by detecting and terminating malignant ventricular arrhythmias. Nationally, ICD implantation is a high‑impact service because of its clinical importance, significant procedural costs, and implications for hospital and device reimbursement.
Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of the clinical context for single‑chamber ICDs, typical sites of service, and the core areas that influence coverage and billing. The publication summarizes common billing considerations, payer coverage patterns, and relevant benchmarks where available, and highlights policy updates and coding clarifications that affect claims processing.
This article is designed for billing professionals, hospital revenue cycle managers, and clinical administrators seeking a national perspective on coding, billing, and policy factors tied to single‑chamber ICD implantation. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code C1722 represents a cardioverter-defibrillator, single chamber (implantable). The service involves implantation of a single‑lead, single‑chamber implantable cardioverter-defibrillator designed to detect and treat life‑threatening ventricular arrhythmias.
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Service type: Implantable cardiac device implantation
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Typical site of service: Hospital inpatient or outpatient surgical setting; cardiac catheterization lab or specialized electrophysiology suite
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with ischemic cardiomyopathy and a history of sustained ventricular tachycardia is evaluated in the cardiology clinic after an admission for syncope and documented polymorphic ventricular arrhythmia. Left ventricular ejection fraction is 28% on echocardiography despite guideline-directed medical therapy. After multidisciplinary review, the electrophysiology team schedules implantation of a single‑chamber implantable cardioverter‑defibrillator for primary prevention of sudden cardiac death.
The clinical workflow includes preoperative evaluation (history, medication reconciliation, device counseling, informed consent), perioperative anesthesia assessment (typically monitored anesthesia care or general anesthesia depending on comorbidity), venous access and lead placement in the right ventricle, generator pocket creation (subcutaneous or subpectoral), device programming and defibrillation threshold testing as indicated, wound closure, and post‑procedure chest x‑ray. Postoperative follow‑up includes device interrogation, wound check, and remote monitoring enrollment. Typical sites of service are the hospital operating room or cardiac electrophysiology lab. The service type is an implantable single‑chamber cardioverter‑defibrillator device implantation procedure represented by C1722.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |