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Coronary Intervention Codes

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

ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes are effective as of October 1, 2015. If you have any questions related to the former ICD-9 or current ICD-10 coding for procedures involving Abbott Vascular devices, please contact the Reimbursement Hotline at 800 354 9997 or Questions@AskAbbottVascular.com.

 

ICD-10-PCS Procedure Codes

ICD-10-PCS tables below are excerpted from the ICD-10-PCS Code Set. Please refer to the official ICD-10-PCS Code Set for complete tables.

ICD-10-PCS Procedure Codes
0      Medical and Surgical
2      Heart and Great Vessels
7      Dilation – Expanding an orifice or the lumen of a tubular body part
Body Part Character 4 Approach Character 5 Device Character 6 Qualifier Character 7
0 Coronary Artery, One Site
1 Coronary Artery, Two Sites
2 Coronary Artery, Three Sites
3 Coronary Artery, Four or More
   Sites
3 Percutaneous 4 Intraluminal Device, Drug-
   eluting
D Intraluminal Device
Z No Device
6 Bifurcation
Z No Qualifier

 

CPT® Procedure Codes/HCPCS Codes

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
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.

 

DES Outpatient Hospital HCPCS Codes

 The following HCPCS codes are used for billing hospital DES outpatient services only. 

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)

 

Vessel Closure

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.

 

Questions about reimbursement for Abbott Vascular Products?

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

 

Last Updated:  November 2015

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

ICD-10 Procedure Coding System (ICD-10-PCS) 2016 Tables and Index, downloaded from http://www.cms.gov/Medicare/Coding/ICD10/2016-ICD-10-PCS-and-GEMs.html on 6/30/2015.

CPT® is a trademark of the American Medical Association.
Current Procedure Terminology (CPT®) is copyright 2014. 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. CPT® 2014. Professional Edition. Chicago, IL.


Disclaimer: The information provided in this document 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 is informational only, general in nature, and does not cover all situations or all payers’ rules and policies. It is the responsibility of the hospital or physician to determine appropriate coding for a particular patient and/or procedure. Any claim should be coded appropriately and supported with adequate documentation in the medical record. A determination of medical necessity is a prerequisite that Abbott Vascular assumes will have been made prior to assigning codes or requesting payments. Any codes provided are examples of codes that specify some procedures or which are otherwise supported by prevailing coding practices. They are not necessarily correct coding for any specific procedure using Abbott Vascular’s products.

Hospitals and physicians should consult with appropriate payers, including Medicare Administrative Contractors, for specific information on proper coding, billing, and payment levels for healthcare procedures. Abbott Vascular makes no express or implied warranty or guarantee that (i) the list of codes and narratives in this document is complete or error-free, (ii) the use of this information will prevent difference of opinions or disputes with payers, (iii) these codes will be covered [or (iv) the provider will receive the reimbursement amounts set forth herein]. Reimbursement policies can vary considerably from one region to another and may change over time.

The FDA-approved/cleared labeling for all products may not be consistent with all uses described herein. This web page is in no way intended to promote the off-label use of medical devices. The content is not intended to instruct hospitals and/or physicians on how to use medical devices or bill for healthcare procedures.
 

 

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