Device-Intensive Procedure and Device Code Search

Published 03/06/2023


The use of a device, or multiple devices, is necessary to the performance of certain outpatient procedures. Conversely, some devices are allowed only with certain procedures, whether the specific device is required. The Outpatient Code Editor (OCE) will return to the provider (RTP) any claim submitted with:

  • A device-intensive procedure code billed without at least one device code required for the procedure on the same claim with the same date of service
  • A device code billed without the procedure code that is necessary for the device to have therapeutic benefit to the patient on the same claim with the same date of service

If a claim RTPs with reason code W7092, the hospital will need to either correct the procedure/device code or ensure that one of the required device/procedure codes is on the claim before resubmission.

Device-Intensive Procedure and Device Code Search

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Additional Billing Guidance

To prevent and/or correct the edit (reason code W7092), verify the following:

  1. The procedure and device code(s) reported on the claim are correct.
  2. The procedure/device code(s) are submitted on the same claim with the same date of service.
  3. If the procedure was discontinued, a device code is not required, but one of the following CPT modifiers should be reported with the procedure code:
    • 52 (Reduced services)
    • 73 (Discontinued outpatient procedure prior to anesthesia administration)
    • 74 (Discontinued outpatient procedure after anesthesia administration)
  5. If there is no applicable HCPCS code for the device, C1889 (Implantable/insertable device, not otherwise classified) may be reported.
  6. For certain device-intensive procedures, providers may bypass the device edit requiring at least one device HCPCS code for the procedure. For situations where no device was performed with certain device-intensive procedures, providers may bypass the edit by reporting HCPCS modifier CG.

References:

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