CCSD Code XR935: Vena Cava Filter Insertion and Removal

Key Takeaways

CCSD code XR935 covers the insertion and/or removal of a vena cava filter under fluoroscopic guidance in UK private practice.

Pre-authorisation from the patient’s private medical insurer is required before performing IVC filter procedures.

Documentation must record the clinical indication, filter type, fluoroscopy use, and any complications to support a valid claim.

Insertion-only and retrieval episodes may require separate billing consideration – confirm modifier requirements with your insurer.

Pabau’s claims management tools support CCSD billing workflows, including CCSD code XR935 submission via Healthcode.

For interventional radiologists and vascular surgeons working in UK private practice, accurate billing for procedural codes is as clinically important as the procedure itself. CCSD code XR935 vena cava filter is the designated code within the Clinical Coding and Schedule Development (CCSD) Group’s schedule for the insertion and/or removal of an inferior vena cava (IVC) filter – a procedure used in the prevention and management of venous thromboembolism. Getting this code right the first time avoids costly claim delays, protects revenue, and keeps your practice’s relationship with major private medical insurers intact.

This guide covers everything a billing administrator or private consultant needs to know: the clinical context for CCSD code XR935, documentation requirements, associated codes, insurer-specific guidance, and the workflow practices that support clean claim submission.

CCSD Code XR935 Vena Cava Filter: What the Code Covers

CCSD code XR935 is listed within the CCSD Group’s schedule of procedures as the relevant code for the insertion and/or removal of a vena cava filter. The code encompasses the fluoroscopy-guided placement of a filter device within the inferior vena cava – a large vein that returns blood from the lower body to the heart – as well as its subsequent retrieval where clinically indicated.

The CCSD Group, which maintains the schedule used by UK private medical insurers, structures codes to reflect the principal procedural episode. For IVC filter work, XR935 is intended to cover the complete procedural episode, whether that involves insertion alone or a retrieval procedure. Billing administrators should note that when insertion and retrieval occur as distinct, separate admissions, insurer-specific guidance may affect how each episode is coded and submitted – this is addressed in more detail below.

CCSD Code XR935 and Filter Types

IVC filters fall into three clinical categories: permanent, temporary, and retrievable. Permanent filters are not designed for removal. Temporary filters are attached to an external catheter and removed within days. Retrievable filters – the most common type in contemporary practice – can remain in place long-term but are designed to allow percutaneous removal once the thromboembolism risk has resolved.

Whether the distinction between filter types carries a separate billing implication under the CCSD schedule should be confirmed directly with the CCSD Group or the treating insurer. Research signals indicate this is an area where coding rules may differ across insurers, and assertions without verified source confirmation carry risk. When in doubt, contact your insurer’s medical fees team before submitting.

Clinical Indications for CCSD Code XR935 Vena Cava Filter Procedures

IVC filter insertion is primarily indicated for patients at high risk of pulmonary embolism (PE) who cannot safely receive anticoagulation therapy. According to guidance from the British Society of Interventional Radiology (BSIR) and consistent with NICE recommendations on venous thromboembolism (VTE) prevention, the core indications include:

• Confirmed deep vein thrombosis (DVT) or PE with a contraindication to anticoagulation (for example, active bleeding, recent surgery, or thrombocytopenia)
• Recurrent VTE despite adequate anticoagulation therapy
• Patients requiring major surgery who have concurrent DVT and cannot delay the procedure
• Massive PE where further embolic events would be life-threatening

Clinical indications must be documented clearly in the patient record. Insurers auditing claims for CCSD code XR935 vena cava filter procedures will expect to see the indication explicitly stated alongside supporting clinical findings. A referral letter or clinic note that simply records the procedure without explaining why it was performed is a common reason for query or rejection.

CCSD Code XR935 Vena Cava Filter Retrieval: Clinical Criteria

Retrieval of a retrievable IVC filter is indicated once the period of high VTE risk has passed and anticoagulation can be safely initiated or resumed. The Royal College of Radiologists (RCR) supports timely retrieval where clinically appropriate, given that long-term filter retention carries its own risks including filter fracture, migration, and caval thrombosis.

For billing purposes, retrieval performed during a separate admission from the original insertion is treated as a distinct procedural episode. Billing administrators using a practice management platform such as Pabau’s claims management software can link separate episode records to the same patient file, maintaining a clean audit trail across both the insertion and retrieval claims.

Documentation Requirements for CCSD Code XR935 Vena Cava Filter Claims

Insufficient documentation is the most predictable cause of claim rejection for interventional radiology procedures. Major UK private medical insurers – including Bupa, AXA Health, Aviva, Vitality, WPA, and Cigna – expect the clinical record to support the procedure billed. For CCSD code XR935, the minimum documentation standard should include the following elements.

CCSD Code XR935 Documentation Checklist

• Confirmed clinical indication: The specific reason for filter insertion – recorded diagnosis, anticoagulation contraindication or failure, and relevant clinical findings (e.g. confirmed DVT on Doppler ultrasound or CT pulmonary angiogram findings)
• Pre-authorisation reference number: All major UK private medical insurers require pre-authorisation for interventional vascular procedures – the authorisation reference must appear on the invoice
• Procedure note: A detailed operative note recording the approach used, filter type and brand, fluoroscopy guidance employed, vascular access site, and any intra-procedural complications
• Fluoroscopy record: Documented confirmation that image guidance was used – this is inherent to the XR935 descriptor and must be evidenced in the clinical record
• Post-procedure note: Filter position confirmation, patient status at discharge, and any follow-up imaging performed
• Consultant details: Name and GMC number of the performing consultant – required for all CCSD invoices submitted to insurers

Private practices billing through structured patient records benefit from having procedure notes, imaging references, and insurer authorisation numbers stored within the same patient file. This substantially reduces the administrative time spent responding to insurer queries after submission.

Billing and Coding Guidance for CCSD Code XR935

Correct application of the CCSD billing schedule for XR935 requires understanding how the code interacts with related procedure codes, anaesthetic billing, and insurer-specific unbundling rules.

CCSD Code XR935 Vena Cava Filter: Insertion-Only vs Combined Episode

Where the same clinician performs both filter insertion and subsequent retrieval, the question of whether these constitute a single billable episode or two separate claims depends on the admission structure. When insertion and retrieval occur during the same admission, the CCSD schedule’s rules around combined episode billing apply – consult the CCSD technical guide for the current business rules governing this scenario. When they occur in separate admissions, each is billed independently using XR935 with the relevant episode details.

Billing administrators should document the admission date and episode structure clearly on the invoice. Insurers comparing insertion and retrieval dates on claims will flag discrepancies if the paperwork does not clearly reflect the clinical timeline.

Anaesthetic Co-billing with CCSD Code XR935

IVC filter insertion is typically performed under local anaesthesia with or without conscious sedation. Where a separate anaesthetist is involved, their fees are billed independently using the relevant CCSD anaesthetic codes. Most major UK private medical insurers apply insurer-specific rules governing whether anaesthetic fees can be co-billed alongside XR935 – confirm this directly with each insurer before submitting a combined claim.

Practices submitting anaesthetic and procedural fees on the same claim via Pabau’s billing and transactions module can generate itemised invoices that clearly separate consultant and anaesthetist fee lines, which is the format most UK insurers require for multi-clinician episode claims.

Streamline your CCSD billing workflows

Pabau supports CCSD code entry, insurer claim submission via Healthcode, and structured patient records that keep your documentation audit-ready. See how private practices manage interventional radiology billing in one place.

Book a demo

Associated CCSD Codes for Vena Cava Filter Procedures

XR935 is rarely billed in isolation. Interventional radiology procedures involve multiple procedural elements, and understanding which associated CCSD codes may apply helps build an accurate, defensible claim. The following codes are commonly relevant to the broader clinical episode, though specific applicability depends on what was performed and whether the insurer permits concurrent billing.

Refer to the Pabau Bupa CCSD codes guide for an overview of how Bupa structures its CCSD schedule and which codes are subject to unbundling restrictions. Bupa, AXA Health, and Aviva each publish their own fee schedules, and the applicable fee for XR935 will vary by insurer and may be updated annually.

Insurer Pre-authorisation and CCSD Code XR935 Vena Cava Filter Claims

Pre-authorisation is a verified standard requirement for all IVC filter procedures across major UK private medical insurers. No claim for CCSD code XR935 vena cava filter insertion or retrieval should be submitted without a confirmed pre-authorisation reference in place. Submitting without authorisation is grounds for automatic rejection regardless of the clinical validity of the procedure.

The pre-authorisation process typically requires the referring consultant or the performing interventional radiologist’s team to contact the insurer directly before the procedure. The request should include the patient’s policy number, the planned procedure and its CCSD code, the clinical indication, and the treating consultant’s details. Most major insurers – including Aviva, Vitality Health, and WPA – operate pre-authorisation portals or dedicated provider lines for this purpose.

Where a procedure is performed as an emergency without the opportunity for pre-authorisation, the insurer must be notified within the timeframe specified in their provider agreement – typically 24-48 hours. Documenting the emergency nature of the procedure and the notification made to the insurer forms a critical part of the post-procedure claim record in these situations.

Practices managing multiple insurer relationships can use compliance management tools to set reminders for pre-authorisation checks as part of a standardised pre-procedure administrative workflow, reducing the risk of procedures proceeding without confirmed insurer approval.

CCSD Code XR935 Vena Cava Filter: Common Claim Rejection Reasons

Understanding why XR935 claims are rejected is as useful as knowing how to code them correctly. The most frequent causes of rejection or query in private practice billing for interventional radiology procedures include:

• No pre-authorisation reference on the invoice – the single most preventable rejection cause
• Clinical indication not documented in the submitted procedure note or referral letter
• Incomplete procedure note – missing fluoroscopy confirmation, filter type, or access site details
• Fee above the insurer’s current schedule rate – fee schedules are updated periodically and practices must check current rates
• Incorrect episode coding – billing insertion and retrieval as a combined episode when the insurer treats them as separate, or vice versa
• Unbundling violations – attempting to bill separately for elements already bundled within the XR935 descriptor

Using a billing platform with structured invoice templates and built-in CCSD code validation – such as Pabau’s claims management software – can catch several of these errors before the claim reaches the insurer. Healthcode, the primary clearinghouse for UK private healthcare billing, processes invoices submitted via practice management systems and returns validation errors before claims enter insurer adjudication.

Expert Picks

Need to understand how Bupa structures its CCSD schedule? Bupa CCSD Codes provides a detailed overview of Bupa’s procedure code framework, fee chapters, and submission requirements for UK private practice.

Looking for a complete practice management system for private billing? Pabau Claims Management Software supports CCSD invoice generation, Healthcode integration, and structured patient records for interventional radiology and other specialist practices.

Want guidance on keeping clinical records audit-ready? Pabau Client Record enables consultants to store procedure notes, imaging references, and insurer authorisation numbers within a single, structured patient file.

Managing CQC compliance alongside CCSD billing? Care Quality Commission (CQC) Role explains how the CQC regulates private healthcare practices in England and what documentation standards apply to clinical record-keeping.

Conclusion

CCSD code XR935 vena cava filter billing sits at the intersection of complex procedural medicine and precise administrative practice. The code covers the insertion and/or removal of an inferior vena cava filter under fluoroscopic guidance, and it is used across UK private medical insurers for interventional vascular procedures within the CCSD schedule. Getting it right requires confirmed pre-authorisation before the procedure, a detailed and complete procedure note, correct episode structure on the invoice, and awareness of each insurer’s current fee schedule and unbundling rules.

For private practices handling interventional radiology billing, a structured workflow – from pre-authorisation through to claim submission – is the most reliable way to minimise rejections and maintain cash flow. Practice management platforms that support CCSD code entry, digital clinical documentation, and Healthcode integration help consolidate that workflow and keep patient records audit-ready at every stage.

Reviewed against current CCSD Group schedule guidance and UK private medical insurer pre-authorisation requirements for interventional radiology procedures.

Frequently Asked Questions