HCPCS code C1751: Catheter, infusion, inserted peripherally

Gather all of the needed information you need like documentation and billing requirements, to properly use and bill for HCPCS code C1751, from our short guide.

Use Code

## **What is HCPCS code C1751?** This HCPCS Level II code, C1751, designates an icatheter, infusion inserted peripherally, centrally, or midline, other than hemodialysis. It covers the physical device used to deliver medication, fluids, parenteral nutrition, or other therapies directly into the vascular system. This includes peripherally inserted central catheters (PICC), midline catheters, or centrally inserted lines as long as they are used for infusion purposes rather than dialysis. The code falls under the category "Catheters for Multiple Applications", serving billing needs in hospital, outpatient, or facility-based settings under OPPS (Outpatient Prospective Payment System) frameworks.

## **HCPCS code C1751 documentation requirements** Thorough documentation is essential for proper billing and to demonstrate medical necessity. For HCPCS code C1751, this typically includes: - **Medical necessity**: The patient's medical record must clearly justify the need for the catheter. This could be due to a need for long-term IV therapy (e.g., antibiotics, chemotherapy, total parenteral nutrition), poor peripheral venous access, or other chronic conditions requiring ongoing infusions. It must also affirm that the catheter is for infusion purposes only and explicitly specify that it is not intended for hemodialysis. - **Procedure documentation**: The medical record should contain a detailed report of the catheter insertion procedure, including the type of catheter used, the insertion site, and confirmation of correct placement. - **Device information**: Documentation should include the specific type of catheter (e.g., PICC, midline), its size, and the manufacturer's information. - **Physician's order**: A signed order from the physician or other qualified healthcare provider must be present, indicating the need for the catheter and the type of therapy it will be used for. - **Goals of care**: For long-term therapy, documentation of the anticipated functional goals of the therapy is important.

## **HCPCS code C1751 billing requirements** HCPCS code C1751 is a "device" code. It's crucial to bill it correctly in conjunction with the associated procedure code. - **OPPS and device-intensive procedures**: This code is primarily used in hospital outpatient settings that are subject to the Outpatient Prospective Payment System (OPPS). In this system, certain procedures are considered "device-intensive," meaning that a separate device code (like C1751) must be billed on the same claim as the procedure code on the same date of service. - **Bundling vs. unbundling**: Many procedures include the cost of supplies and devices in the overall reimbursement. However, for a device-intensive procedure, the device may be separately billable. It's important to verify the specific billing policies of the payer (e.g., Center of Medicard and Medicaid Services (CMS) private insurers) as these can vary. - **Single-use device**: This code is for a single-use, insertable catheter. If the device is removed before the end of the procedure, it may not be separately reportable. - **Modifiers**: Depending on the specific circumstances and payer rules, modifiers may be needed to accurately represent the service provided.

## **Other relevant codes** - **C1750**: Catheter, hemodialysis/peritoneal, long-term. This code is for a similar device but specifically for hemodialysis, which is an important distinction from C1751. - **C1752**: Catheter, hemodialysis/peritoneal, short-term. Similar to C1750, but for short-term use. - **C1788**: Catheter, extravascular, infusion, implantable, totally implantable. This code is for an implanted port-a-cath, which is a different type of access device that remains in the body long-term. - **S5520**: Home infusion therapy, all supplies (including catheter) necessary for a peripherally inserted central venous catheter (PICC). This is a temporary, non-Medicare code used for home care settings. - **S5522**: Home infusion therapy, insertion of peripherally inserted central venous catheter (PICC), nursing services only (no supplies or catheter).

Frequently asked questions

No. C1751 explicitly excludes hemodialysis or peritoneal dialysis catheters. Those use separate codes, such as C1750 (long-term) or C1752 (short-term), for dialysis catheters.

Clinical notes must confirm the catheter's site of placement, intended use (infusion only), and non-dialysis purpose. Operative or insertion records and device logs should verify the specific catheter model and use to support accurate assignment of C1751.

No, C1751 is an HCPCS Level II code, not a CPT code. HCPCS codes are used to identify products, services, and other medical supplies or medical items not included in the CPT codes.