(PCI) CORONARY INTERVENTIONS

MAjOR CORONARY ARTERIES ANd BRANChES

CORONARY ARTERIES ANd BRANChES Of ThE hEARTBASE COdE hIERARChY (+ AddITIONAl COdES)

left Anterior descending ld/lAd left Circumflex Artery lC Right Coronary Artery R/RCA Diagnonals (D1/D2) Obtuse Marginals (OM1/OM2) Posterior Descending (PDA)left Main lM Ramus Intermediate RI Posterior Lateral (PL)

Atherectomy 92924 each add’l branch atherectomy 92925 (use 92925 with 92924,92928,92933,92937,92941,92943)

PTCA - Angioplasty 92920each add’l branch PTCA 92921 (use 92921 with 92920,92924,92928,92933,92937,92941,92943)

Revasc In and/or Through Bypass Graft 92937 each add’l subtended bypass graft 92938 (use 92938 with 92937)Stent w/ or w/o Balloon 92928 each add’l branch stent 92929 (use 92929 with 92928, 92933, 92937, 92941, 92943)

• PCI’s performed in any segment (proximal, mid, distal) of a major coronary artery is reported with one code.

• PCI is reported for up to two branches of 3 major coronary arteries. PCI in a third branch of the same major coronary artery is not separately reportable.

• All intervention codes include angioplasty (PTCA) if performed.• For bifurcation lesions code both vessels treated.• Bypass Sequential graft represents 1 graft – even with more than one

distal anastomosis• Use two base codes (one bypass & one primary) if lesions in both native

& in or through bypass performed• CTO = “bridging” collaterals, calcification at the occlusion site, no

current presentation with ST elevation or Q wave AMI.

PCI COdING TIPS

CTO - Chronic Total Occlusion 92943 each add’l CTO - Chronic Total Occlusion 92944 (use 92944 with 92924,92928,92933,92937,92941,92943)Revasc of Total/Subtotal Occlusion - AMI 92941 (for add’l vessels tx’d see 92920-92938,92942,92944)Stent + Atherectomy w/or w/o PTCA 92933 each add’l branch stent + atherectomy 92934 (use 92934 with 92933,92937,92937,92941)

TAVRTAVR, percutaneous femoral appr 33361TAVR, open femoral approach 33362TAVR, Transapical approach 33366+ Bypass Support w/percutaneous arterial/venous cannulation 33367+ Bypass Support w/open arterial/venous cannulation 33368+ Bypass Support w/central arterial/venous cannulation 33369TAVR, open axillary artery approach 33363TAVR, open iliac approach 33364TAVR, Transaortic approach 33365

Insertion, percutaneous, arterial access only (i.e. Impella), incl S/I 33990Insertion, percutaneous, arterial and access (i.e. Tandem heart), incl S/I 33991Removal at separate and distinct session 33992Repositioning at separate and distinct session 33993

pVAd

PUBLISH DATE 1/2014

CORONARY dIAGNOSTIC PROCEdURES (hEART CATh)

CORONARY (hEART CATh) PROCEdURES COMMON Add ON COdES

dIAGNOSTIC CATh TIPS

lhC +/- LV, cors 93458LHC +/- LV, cors, GRAfTS 93459Cors ONLY 93454Cors ONLY with GRAfTS 93455RhC 93451RHC w/ CORS 93456RHC w/Cors, GRAfTS 93457RhC/lhC +/- LV 93460RhC/lhC +/- LV, GRAfTS 93461

Supravalvular aortography (root) 93567RA or RV angiography 93566Pulmonary angiography 93568Pharm Agent Assessment 93463Exercise Study Assessment 93464Transseptal/Transapical approach 93462Non-selective RENAlS w/Cath G0275Non-selective IlIACS w/Cath G0278Unilateral SELECTIVE Renal 36251Bilateral SELECTIVE Renal 36252fractional flow Reserve (ffR) initial 93571fractional flow Reserve (ffR) add’l 93572Thrombectomy (mechanical) 92973IVUS initial vessel 92978IVUS each additional vessel 92979Insertion of IABP 33967Removal of IABP 33968Swan-Ganz (leave in for monitoring) 93503

Coronary Angiography 93563Venous or Arterial Graft(s) 93564LA or LV Angiography 93565

Separately billable same setting when: • No prior catheter based coronary angiography • A prior study available but as documented: – Condition with respect to clinical indication has changed

since prior study – Inadequate visualization of anatomy – Clinical change during the procedure that requires new evaluation

outside the target area of intervention

CONGENITAl ONlY Add ON COdES

Margie Amato • VP – Revenue Cycle Solutions • 801.947.8701 • mamato@medaxiom.com

Nicole Knight • Director – Revenue Cycle Solutions • 904.372.2165 • nknight@medaxiom.com

CONGENITAl CATh COdES

RHC for congenital anomalies 93530RHC and retro LHC 93531RHC/Transseptal LHC thru 93532 intact septum +/- retro LHC RHC/Transseptal LHC thru 93533 existing septal opening +/- retro LHC