Coronary Diagnostic and Intervention Coding Sheet

2022 Coronary Diagnostic and Intervention Coding Sheet

Patient: Refer.MD:

Date of Birth: DX:

Date of Procedure:

Reimbursement Information Line Tel: 877.347.9662

CPT? codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Fee schedules, relative value units, conversion factors and/or related components aren't assigned by the AMA, aren't part of CPT?, and the AMA isn't recommending their use. The AMA doesn't directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

DIAGNOSTIC (NON-CONGENITAL)

Right heart catheterization

93451

Left heart catheterization, inc. left ventriculography

93452

Combined left and right heart catheterization, inc. left ventriculography

93453

Coronary angiography

93454

Coronary angiography w/o left or right heart cath, with angiography of bypass graft(s)

93455

Coronary angiography w/ right heart cath

93456

Coronary angiography w/ angiography of bypass graft(s) & right heart cath

93457

Coronary angiography w/ left heart cath, including left ventriculography

93458

Coronary angiography w/ left heart cath w/ angiography of bypass graft(s) inc. left ventriculography

93459

Coronary angiography w/ left & right heart cath, inc. left ventriculography

93460

Coronary angiography w/ left & right heart cath, w/ angiography of bypass

93461

graft(s) inc. left ventriculography

DIAGNOSTIC (CONGENITAL)

Right heart catheterization for congenital heart defect(s) inc. imaging guidance; 93593

normal native connections

Right heart catheterization for congenital heart defect(s) inc. imaging guidance; 93594

abnormal native connections

Left heart catheterization for congenital heart defect(s) inc. imaging guidance, normal or abnormal native connections

93595

Right and left heart catheterization for congenital heart defect(s) inc. imaging;

93596

normal native connections

Right and left heart catheterization for congenital heart defect(s) inc. imaging;

93597

abnormal native connections

Cardiac output measurement(s), thermodilution or other indicator dilution

+93598

method, performed during cardiac catheterization for the evaluation of

congenital heart defects

Injection procedure, including S&I, for selective coronary angiography during congenital heart cath

+93563

Injection procedure, including S&I, for selective angiography of venous or arterial +93564

bypass graft(s) during congenital cath

Injection procedure, including S&I, for selective left ventricular or left atrial angiography during congenital heart cath

+93565

ADDITIONAL INJECTIONS

Injection procedure for selective right ventricular or right atrial angiography

+93566

Injection procedure for supravalvular aortography

+93567

Injection procedure for pulmonary angiography

+93568

MODERATE SEDATION

Moderate sedation codes are based on the documented physician face-to-face time beginning when the patient is administered sedation and ends when the patient no longer requires physician monitoring, or when the physician leaves the room.

MD performing svc initial 15 min. intra-svc time; < 5 years old

MD performing svc initial 15 min. intra- svc time; >5 years old

+ each additional 15min. intra-service time

MD not performing service initial 15 minutes intra-service time;< 5 years old

MD not performing service initial 15 minutes intra-service time;> 5 years old

+ each additional 15min. intra-service time

ADDITIONAL PROCEDURES

Intravascular ultrasound or OCT (coronary vessel or graft), initial vessel Intravascular ultrasound or OCT(coronary vessel or graft), each additional vessel Left heart catheterization by trans septal puncture Pharmacologic agent administration including hemodynamic measurements* Physiologic exercise study including hemodynamic measurements Insertion and placement of flow-directed catheter for monitoring purposes (Swan-Ganz) Endomyocardial biopsy Indicator dilution studies including arterial and/or venous catheterization, with cardiac output measurement (separate procedure) Indicator dilution studies, subsequent measurement of cardiac output Intravascular Doppler velocity and/or pressure-derived coronary flow reserve measurement (FFR), during coronary angiography, initial vessel Intravascular Doppler velocity and/or pressure-derived coronary flow reserve measurement (FFR), during coronary angiography, each additional vessel Iliac and/or femoral artery angiography, nonselective, bilateral or ipsilateral to cath insertion during cardiac cath or coronary angiography Closure device into venous or arterial access site

SELECTED INTERVENTIONS

Percutaneous transluminal coronary thrombectomy, mechanical* Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel

99151 99152 +99153 99155 99156 +99157

+92978 +92979 +93462 +93463 +93464

93503

93505 93561

93562 +93571

+93572

G0278

G0269

+92973 +92974

92975

92997 +92998

1 | 2022 Coronary Diagnostic and Intervention Coding Sheet US | January 2022 | UC202007843cEN

Note: Medtronic doesn't offer products with approved indications for all procedures listed.

MAJOR CORONARY ARTERIES & BRANCHES

? The PCI codes are Major Coronary Artery

set up as base codes Left main coronary artery

and add-on codes. Left anterior descending

? Base codes are

coronary

assigned for the five artery

major coronary arteries.

Left circumflex coronary artery

? Add-on codes are

assigned for branches of the

Right coronary artery

major coronary

arteries. Only two

branches of each major coronary

Ramus intermedius coronary

artery can be coded. artery

Modifier Branches LM None LD Diagonal 1 Diagonal 2

LC Obtuse marginal1

Obtuse marginal2

RC Right posterior Descending Right posterolateral

RI None

BASIC CODING RULES

All PCI codes are bundled and include vascular access, selective catheterization, traversing the lesion, radiological S&I, completion imaging and closure. ? PCI within a single major artery is reported with one code, regardless of whether

several discrete lesions were treated.

? For PCI on a major artery and one of its branches, a base code and an add-on code are assigned.

? For PCI on two different major arteries, two base codes are assigned. Use modifiers to differentiate the major arteries.

? For PCI on a major artery and the branch of another, two base codes are assigned.

? When a single lesion bridges two vessels but is treated with a single intervention, only one code is reported.

? When bifurcation lesions are treated, intervention codes are reported for both vessels.

? Cardiac catheterization and coronary angiography may be coded separately only when specifically diagnostic.

CPT? 92920 +92921 92924 +92925 92928 +92929 92933 +92934

92937

+92938 92941 92943 +92944

CPT Description Coronary Angioplasty w/o stent + each additional artery Coronary Atherectomy w/o stent + each additional artery Coronary BMS or DES + each additional artery Coronary BMS or DES w/ Atherectomy + each additional artery Coronary BMS or DES Bypass Graft Revascularization, single vessel + each additional artery Coronary AMI any PCI, single vessel Coronary BMS or DES w/ CTO + each additional artery

2022 FACILITY RVUs

Work

PE

MP TOTAL

9.85

3.43

2.25 15.53

bundled for physicians

11.74 4.08

2.69 18.51

bundled for physicians

10.96 3.81

2.51 17.28

bundled for physicians

12.29 4.26

2.83 19.38

bundled for physicians

10.95 3.80

2.51 17.26

bundled for physicians

12.31 4.28

2.83 19.42

12.31 4.27

2.84 19.42

bundled for physicians

HOSPITAL CODING HCPCS II

Note: Hospitals use the regular CPT? stent codes to report placement of non-drug-eluting stents only. They use the HCPCS "C codes" below to report placement of drug-eluting stents. Physicians do not use C codes and report the regular CPT? codes for placement of all stents.

C9600 - Coronary DES +C9601 - each additional artery C9602 - Coronary DES w/ Atherectomy +C9603 - each additional artery C9604 - Coronary DES Bypass Graft Revascularization, single vessel +C9605 - each additional artery C9606 - Coronary DES Coronary w/ AMI C9607 - Coronary DES w/ CTO C9608 - each additional artery

CPT? codes, descriptions and other data only are copyright 2021 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply. Fee schedules, relative value units, conversion factors and/or related components aren't assigned by the AMA, aren't part of CPT?, and the AMA isn't recommending their use. The AMA doesn't directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Code descriptions have been abbreviated in this document. For specific AMA descriptions of current CPT? coding, please refer to the most recent version of the CPT? Coding Book. Medtronic does not represent or guarantee that this information is complete, accurate, or applicable to any particular patient or third party payer. Medtronic disclaims all liability for any consequence resulting from reliance on this document. The final decision of billing for any service must be made by the health care provider considering the medical necessity of the service furnished as well as the requirements of third-party payers and any local, state, or federal laws and regulations that apply. Medtronic is providing this information in an educational capacity with the understanding that Medtronic is not engaged in rendering accounting, or other professional services. Medtronic encourages all health care providers to consult with their own advisors regarding coding and payment. All Medicare rates displayed in this document reflect the "national unadjusted" amounts inclusive of beneficiary cost-sharing and do not reflect any additional payment adjustments, such as the 2% sequester reduction mandated by the Budget Control Act of 2011 or the 4% PAYGO reduction triggered by the American Rescue Plan in December 2020. Please note that on December 10, 2021, legislation was enacted to delay the 2% sequestration for 3 months (January 1?March 31, 2022), followed by a reduction of 1% for 3 months (April 1?June 30, 2022). The full 2% sequestration cut will go back into effect on July 1, 2022. The 4% PAYGO reduction was postponed through January 1, 2023. Medtronic doesn't offer products with approved indications for all procedures listed. For more information, contact the Cardiovascular Health Economics, Policy & Reimbursement Team.

2 | UC202007843cEN ?2022 Medtronic. Medtronic, Medtronic logo, and Engineering the extraordinary are trademarks of Medtronic. All other brands are trademarks of a Medtronic company. 01/2022

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