Cardiology Coding Alert

Question: Can I use 92973 to report an AngioJet performed without PTCA or stent?


South Carolina Subscriber

Answer: No. Your physician has to provide a stent or PTCA to report +92973 (Percutaneous transluminal coronary thrombectomy [list separately in addition to code for primary procedure]). You must use 92973 with the following codes, according to a note in the CPT manual:

• 92980 -- Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel

• 92982 -- Percutaneous transluminal coronary balloon angioplasty; single vessel.

Code 92973 is an add-on code, which means it describes additional intraservice work associated with the primary procedure. You must never report an add-on code as a stand-alone code, according to CPT guidelines. Your CPT manual denotes add-on codes with a "+" symbol.

Payers generally refuse payment for AngioJet if 92980 or 92982 isn't on the claim, but you may try using an unlisted-procedure code, such as 76499 (Unlisted diagnostic radiographic procedure) or 93799 (Unlisted cardiovascular service or procedure).

Remember: Carriers automatically review unlisted-procedure codes. Therefore, you should submit your claim manually with the patient's record, which should clearly and accurately document the intracardiac echocardiogram and why the cardiologist performed it. The carrier will likely scrutinize the notes to determine if this service qualifies as a "medically necessary" service.

Some payers, including Medicare carriers, have reportedly not allowed you to submit claims on paper initially. For these payers, you will need to file an electronic claim first. The payer will deny the claim and request additional information before processing. 

Best bet: Try basing your pricing for an unlisted-procedure code on 93508 (Catheter placement in coronary artery[s], arterial coronary conduit[s], and/or venous coronary bypass graft[s] for coronary angiography without concomitant left heart catheterization) as well as 92973.