HCPCS C1760: Closure device, vascular (implantable/insertable)

Gain a better understanding of how to properly use and bill HCPCS code C1760 with our short guide.

## **What is HCPCS code C1760?** HCPCS code C1760, a code that has a service type of "Assorted Devices, Implants, and Systems under the Outpatient Prospective Payment System (OPPS)", is described as "Closure device, vascular (implantable/insertable)." This code identifies a vascular closure device (VCD), which is a medical implant used to seal the puncture site in a blood vessel after a catheterization or other vascular procedure (e.g., angiography or angioplasty). The purpose is to achieve immediate hemostasis (stopping of bleeding) and promote quicker patient recovery. The equipment is considered an insertable device because, while it is placed in the body, it is a single-use device used during the procedure. However, the closing mechanism (like a collagen plug or suture) may remain.

## **HCPCS code C1760 documentation requirements** The documentation must clearly support the use of the device and meet the definition of an implant or insertable device for the facility. Key requirements generally include: - **Medical necessity**: Clear documentation in the patient's medical record justifying the use of a vascular closure device instead of other alternatives (like manual compression). - **Procedure report**: The operative or procedure report must detail the use of the specific vascular closure device (including the device's name or type, if possible). - **Device classification**: Since C1760 describes a device, the medical record and claim must align with the payer's (e.g., Medicare/CMS, private insurer) definition of an implantable/insertable device, which typically involves it being an integral part of the service, used for one patient only, coming into contact with human tissue, and being surgically implanted or inserted. - **Same claim/date of service**: For facility billing, the device code (C1760) must be reported on the same claim and with the same date of service as the primary procedure (e.g., cardiac catheterization) it was used for.

## **C1760 billing requirements** To ensure that C1760 is properly reimbursed, the following guidelines or requirements must be considered: - **Payer context**: C-codes are primarily used by hospitals for billing services to patients covered under Medicare OPPS. Hospitals are generally encouraged to report all applicable C-codes for cost-reporting purposes, even if the device payment is "packaged" into the reimbursement for the primary procedure. - **Reimbursement status**: C1760 is often a packaged code under OPPS (Status Indicator "N" or similar, depending on the specific primary procedure). This means the payment for the device is bundled into the Ambulatory Payment Classification (APC) payment for the primary procedure, and the device is not separately reimbursed. - **Revenue code**: Hospitals often report C-codes on the UB-04 claim form using a relevant revenue code, such as 0278 (Medical/Surgical Supply – Other Implant) or 0360 (Operating Room Services - General). - **Bundling Issues**: Payer policies often consider the vascular closure device to be a component of the primary cardiac or vascular procedure. Some payers (e.g., specific Blue Cross Blue Shield plans) may deny reimbursement based on internal policies that require the device to remain in the body and not be absorbable for separate payment.

## **Other relevant codes** - **C1761**: Catheter, transluminal intravascular lithotripsy, coronary - **C1889**: Implantable/insertable device, not otherwise classified - **G0269**: Placement of occlusive device into either a venous or arterial access site, post-surgical or interventional procedure (e.g., angioseal plug, vascular plug) - **C1769**: Guide wire - **C1713**: Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable) - **C1889**: Implantable/insertable device for device-intensive procedure, not otherwise classified

Frequently asked questions

Generally, no. Under Medicare OPPS, it is typically a packaged code, meaning its cost is included in the payment for the primary surgical procedure (e.g., a cardiac catheterization) and does not receive separate reimbursement.

HCPCS code C1760 identifies the device itself (the vascular closure device). The CPT code describes the procedure (the service performed by the physician and hospital) where the device was used, such as an angiography.

It is classified as an insertable device by some sources, as it is used during the procedure, and the core of the device may be removed. However, the mechanism that closes the vessel is often left behind (e.g., suture or collagen plug), qualifying it for this category.