Cardiology Coding Alert

The aspiration thrombectomy question finally gets an answer.

The 2013 addition of the term "mechanical" to thrombectomy code +92973 has coders clapping for clarity:

2012: +92973, Percutaneous transluminal coronary thrombectomy

2013: +92973, Percutaneous transluminal coronary thrombectomy mechanical.

There has been a lot of confusion in the past about whether coders could use +92973 for more than mechanical thrombectomy, specifically whether the code applied tor aspiration thrombectomy, says Julie Graham, BA, CPC, cardiology coder and compliance specialist for Concentra.

By specifying "mechanical," the code definition change resolves that confusion, says Graham. Be sure to check the guidelines, too, she adds. The 2013 guidelines state, "Non-mechanical, aspiration thrombectomy is not reported with 92973, and is included in the PCI code for acute myocardial infarction (92941), when performed."

The language change lines up with an article in CPT® Assistant (March 2002) from the year when the code was created. CPT® Assistant stated that +92973 was added to describe a catheter-based angiojet "procedure using a unique method of fragmenting and removing clots from the coronary artery" lumen. A vignette in the article describes a reportable thrombectomy that includes advancing the thrombectomy catheter distal to the lesion, activating the catheter using a foot pedal, and then manually withdrawing the catheter to remove the thrombus (repeating as needed).

Bonus: If the physician provides non-mechanical thrombectomy without percutaneous coronary intervention (PCI), experts recommend reporting 93799 (Unlisted cardiovascular service or procedure) for this stand-alone procedure. For instance, a physician may decide to end the procedure after providing a non-mechanical aspiration without other PCI services.