April 24, 2026

In this episode, Scott, Mark, and Dr. Ray Painter break down the latest guidance on HCPCS code C9761 and the growing confusion around what qualifies for payment under this new technology APC. They walk through key interpretations from the AHA, AMA, and MACs, highlighting the critical distinction between steerable ureteral catheters, scopes, and access sheaths—and why that difference can determine whether a case is paid or denied. The discussion emphasizes the importance of precise physician documentation, understanding device labeling, and verifying payer-specific policies before billing. The takeaway: while new technology offers higher reimbursement potential, it also introduces real risk—making clarity, compliance, and payer alignment essential.

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UCR 286: C9761 Clarified – What Actually Qualifies and What’s at Risk