2025 HCPCS code C1890
(Not Paid by Medicare for Hospital Outpatient Claims) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Durable Medical Equipment (DME) - Assorted Devices, Implants, and Systems C-Codes Feed
No implantable/insertable device used with device-intensive procedures.
Medical necessity must be established for the underlying device-intensive procedure performed. The reason for not using a device should be clinically justified and documented.
The physician performing the device-intensive procedure is responsible for reporting this code when no device is implanted or inserted.
In simple words: This code is used when a complex medical procedure, that usually involves implanting a device, is performed without actually implanting the device.It tells the insurance company that even though no device was used, the procedure was still complex and should be reimbursed accordingly.
This code is used to report that a device-intensive procedure was performed in the hospital outpatient setting, but no implantable or insertable device was utilized during the procedure. Device-intensive procedures may receive a higher value for payment purposes when such a device is involved. This code helps ensure appropriate costs are captured for future outpatient payment adjustments.
Example 1: A patient undergoes a complex laparoscopic procedure that typically involves the placement of a surgical mesh, but due to patient-specific factors, the mesh is not used. C1890 would be reported., A patient receives a device-intensive cardiac catheterization procedure for diagnostic purposes only, without any stent placement., A patient has a planned device-intensive procedure, but during the procedure, complications arise, and the physician decides not to implant the device.
Documentation should support the medical necessity of the device-intensive procedure and clearly state that no implantable or insertable device was used. The operative report should detail why the device was not used.
** It's crucial to consult the latest Medicare guidelines and specific payer policies for up-to-date information regarding the payment status of C1890.As of December 1st, 2024,Medicare does not pay for this code when billed by hospital outpatient departments.Always verify current coding and billing rules for accurate claim submission.
- Revenue Code: 270 (Medical-Surgical Supplies)
- Payment Status: Not paid by Medicare when submitted on outpatient claims (any outpatient bill type) from hospital outpatient departments. Payable in the Ambulatory Surgical Center (ASC) setting.
- Specialties:Various surgical specialties depending upon the specific device-intensive procedure performed (e.g., cardiology, cardiovascular surgery, general surgery).
- Place of Service:Ambulatory Surgical Center (ASC)