`C9760` Non-blind interatrial shunt

Non-randomized, non-blinded procedure for nyha class ii, iii, iv heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study

Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction
Outpatient hospital: max 1 units per day (policy), rationale: Code Descriptor / CPT Instruction

Payer policies and prior authorization for C9760

Payer coverage policies that name C9760

C9760 appears in 1 coverage policy from Capital Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Cardiac	listed, no stance	Sep 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

AZ: $8083.97 (asc), effective Oct 1, 2026
ND: $8501.95 (physician, facility), effective Aug 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WY: $11903.90 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

C9760 Non-blind interatrial shunt

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C9760

Payer coverage policies that name C9760

Medicaid fee-for-service

`C9760` Non-blind interatrial shunt