C9792 — Blinded or nonblinded procedure for symptomatic new york heart association (nyha) class ii, iii, iva heart failure; transcatheter implantation of left atrial to coronary sinus shunt using jugular vein access, including all imaging necessary to intra procedurally map the coronary sinus for optimal shunt placement (e.g., tee or ice ultrasound, fluoroscopy), performed under general anesthesia in an approved investigational device exemption (ide) study)
HCPCS/CPT
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- For PDA: clinical documentation supporting device selection (policy references use of Amplatzer ductal occluder in moderate-to-large PDAs and prior trials showing use in pediatric population).
- General documentation implied by policy: pre-procedure and follow-up echocardiography (TEE/TTE) and clinical follow-up notes (policy cites necessity of pre-procedure and post-procedure echo and follow-up schedules in clinical studies).
- No explicit documentation requirements (e.g., precise CMS/Medicare medical necessity statement or required ICD-10 documentation) are stated in the provided text.