Summary & Overview
HCPCS Level II M1455: Replacement or Revision of Device Component
HCPCS Level II code M1455 denotes a procedure described as “Replaced or revised cied,” indicating replacement or revision of a device or implant component. This code is used to classify and bill for surgical interventions involving modification or exchange of a component in a medical device. Nationally, accurate identification and use of this code affect hospital and ambulatory surgical center billing, device management, and claims adjudication.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for device replacement or revision procedures, benchmarks for payer coverage and coding practice where available, and relevant policy and reimbursement considerations impacting billing across major national payers. The publication outlines how M1455 is positioned within service lines that manage implanted devices and what operational areas—such as surgical scheduling and claims processing—are most affected.
The report provides clear, actionable information on code definition, expected settings of service, and the types of procedures it represents, helping billing staff, clinical coders, and revenue cycle managers understand when M1455 applies and what documentation is typically necessary. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code M1455 represents a service described as Replaced or revised cied. Based on the description, the service type is a procedure involving replacement or revision of a device or implant component. The typical site of service for this procedure is an operative or surgical setting such as an ambulatory surgical center or hospital operating room.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents for replacement or revision of a cochlear implant external or internal component due to device failure, infection, extrusion, or device upgrade. The patient has a history of severe-to-profound sensorineural hearing loss and previously underwent cochlear implantation. Pre-procedure workup includes audiologic testing, device interrogation, otologic examination, and imaging (CT or MRI as indicated) to evaluate electrode position and rule out complications. The clinical workflow involves scheduling perioperative evaluation, obtaining informed consent, performing device removal and replacement or revision under general anesthesia in an ambulatory surgery center or hospital operating room, intraoperative device testing and electrode impedance/telemetry checks, and postoperative audiology mapping and follow-up for wound care and device programming. Typical site of service is an ambulatory surgery center or hospital operating room for the surgical revision or replacement procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | When a separate, distinct procedural service is performed on the same day unrelated to the implant revision. |
76 |