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Coding, Coverage, and Reimbursement Resources



CMS C-code Requirements

Effective January 1, 2005, CMS began requiring hospitals to bill appropriate C-codes for all device-dependent Ambulatory Payment Classifications (APCs). If a hospital outpatient bill includes a device-related CPT/HCPCS II procedure code but the C-code for the associated device is not present, the claim is edited and returned to the hospital. Furthermore, if a C-code is billed without the appropriate procedure code, the claim will be returned.

For most C-codes, the hospital does not receive additional reimbursement for devices. The C-codes are required because CMS is collecting charge data for these devices for use in setting future reimbursement rates.

Below is a downloadable PDF document listing Vascular product names and their associated C-codes.

icon-pdf Download product names and C-codes