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Coronary Intervention Codes

 

 

Questions about coding for Abbott Vascular Products?

Contact the Reimbursement Hotline: 800 354 9997 Questions@AskAbbottVascular.com.

 

 

Below you will find general coding information related coronary interventions. Providers should consult with their payers regarding appropriate documentation, medical necessity and coding information consistent with individual payer

 

ICD-9-CM Procedure Codes

The following section contains commonly used hospital billing codes for coronary interventions and devices.

Note: Medicare hospital inpatient information is effective for the fiscal year (FY) (October 1 through September 30).

ICD-9-CM Procedure Codes
36.06 Insertion of non-drug eluting coronary artery stent(s)
36.07 Insertion of drug-eluting coronary artery stent(s)
ICD-9-CM Procedure Codes
00.66 Percutaneous transluminal coronary angioplasty

 

Code also any:

ICD-9-CM Procedure Codes
00.45 Insertion of one vascular stent/Number of stents unspecified
00.46 Insertion of two vascular stents
00.47 Insertion of three vascular stents
00.48 Insertion of four or more vascular stents

ICD-9-CM Procedure Codes

00.40 Procedures on single vessel/Number of vessels, unspecified
00.41 Procedure on two vessels
00.42 Procedure on three vessels
00.43 Procedure on four or more vessels
00.44 Procedure on vessel bifurcation

 

CPT-4® Procedure Codes/HCPCS Codes

New Coronary CPT Codes

For 2013, Medicare deleted six coronary intervention codes that range from 92980-92996 and replaced them with the codes in the table below.

CPT® Codes               
92920 Percutaneous transluminal coronary angioplasty; single major coronary artery or branch
92921 Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
92924 Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch
92925 Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
92928 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
92929 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
92933 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
92934 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
92937 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
92938 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure)
92941 Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
92943 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel
92943 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel
92944 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (List separately in addition to code for primary procedure)

 

Note: Six of the foregoing codes are separately reportable (92921, 92925, 92929, 92934, 92938, and 92944), when performed, but for payment purposes are bundled into the code immediately preceding each of them in the coding system shown above. Also refer to the table on the Coronary Payment Web page.

New DES Outpatient Hospital HCPCS Codes

For 2013, Medicare deleted the HCPCS codes G0290 and G0291 for reporting DES procedures.  The following HCPCS codes are used for billing hospital DES outpatient services only.  For billing of physician DES procedures, refer to 92928 and 92929 in the table above.

HCPCS Codes
C9600 Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
C9601 Percutaneous transcatheter placement of drug-eluting intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure
C9602 Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch
C9603 Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)
C9604 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel
C9605 Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure)
C9606 Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
C9607 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel
C9608 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (List separately in addition to code for primary procedure)

 

The following code has been assigned to occlusive devices by CMS: G0269

G0269 is defined as: placement of an occlusive device in either a venous or arterial access site, post-surgical or interventional procedure. Code G0269 should be used on Medicare claims to record the placement of the vasoseal and for other payers as directed.

Last Updated - December 2012

References:

Centers for Medicare and Medicaid Services at www.cms.gov

ICD-9-CM for Hospitals  - Volumes 1,2 & 3; 2012 Professional; 6th edition; edited by Anita C. Hart, RHIA, CCS, CCS-P, Melinda S. Stegman, MBA, CCS, Beth Ford, RHIT, CCS; Ingenix

CPT® is a trademark of the American Medical Association.

Current Procedure Terminology (CPT®) is copyright 2011. American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.

American Medical Association. Current Procedural Terminology (CPT®) 2012. Professional Edition. Chicago, IL.

Disclaimer: The information provided on this website was obtained from third-party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, policies, and payment amounts. All content on this website is informational only, general in nature, and does not cover all situations or all payers' rules and policies. This content is not intended to instruct hospitals and/or physicians on how to use or bill for healthcare procedures, including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that Abbott Vascular assumes will have been made prior to assigning codes or requesting payments. Hospitals and physicians should consult with appropriate payers, including Medicare fiscal intermediaries and carriers, for specific information on proper coding, billing, and payment levels for healthcare procedures.

This website information represents no promise or guarantee by Abbott Vascular concerning coverage, coding, billing, and payment levels. Abbott Vascular specifically disclaims liability or responsibility for the results or consequences of any actions taken in reliance on information on this website.

 

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