HCPCS Code C7513

Official Description

Dialysis circuit, introduction of needle(s) and/or catheter(s), with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, with transluminal balloon angioplasty of central dialysis segment, performed through dialysis circuit, including all required imaging, radiological supervision and interpretation, image documentation and report

Short Descr	Cath/angio dialcir w/aplasty
Coverage	Carrier Priced
Pricing Indicator(s)	11 – Physician Fee Schedule - Price established using national RVUs
MPI	A – Not applicable, as HCPCS priced under one methodology
ASC Payment Group Code	YY – 1/01/2023
Processing Note	THESE CODES ARE USED ONLY UNDER THE ASC PAYMENT SYSTEM. REFER TO THE 2023 OPPS/ASC FINAL RULE AND THE DISCUSSION ON THE ASC SPECIAL PAYMENT POLICY FOR OPPS COMPLEXITY-ADJUSTED C-APCs FOR MORE INFORMATION.
BETOS	P6C – Minor procedures - other (Medicare fee schedule)
TOS Code(s)	2 – Surgery
Added Date	1/1/2023
APC Status Indicator	Non-Covered Service, not paid under OPPS
ASC Payment Indicator	Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
MUE	1
MUE	Not applicable/unspecified.
OTS Orthotic	No

51	Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
RT	Right side (used to identify procedures performed on the right side of the body)
74	Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
79	Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
GV	Attending physician not employed or paid under arrangement by the patient's hospice provider
GW	Service not related to the hospice patient's terminal condition
LT	Left side (used to identify procedures performed on the left side of the body)
SG	Ambulatory surgical center (asc) facility service
XS	Separate structure, a service that is distinct because it was performed on a separate organ/structure