Cardiology Coding Alert

Question: What are kissing balloons, and what’s the rule on reporting them in coronary interventions?

California Subscriber

Answer: “Kissing balloon” refers to two balloons that the cardiologist inserts in a way that keeps them close together, inflating them at the same time. The technique treats bifurcation lesions, meaning lesions located where a vessel branches, or bifurcates.

CPT® guidelines for 92920-92944 state that you should report percutaneous coronary intervention (PCI) for both vessels when the physician treats bifurcation lesions. 

The kissing balloon angioplasty example stated above supports coding 92920 (Percutaneous transluminal coronary angioplasty; single major coronary artery or branch) and +92921 (… each additional branch of a major coronary artery [List separately in addition to code for primary procedure]). 

Remember to always follow the hierarchy depending on procedural services performed. For instance, the bifurcation lesion example CPT® gives in the code guidelines is of stenting a bifurcation lesion of the left anterior descending and first diagonal artery and capturing both using 92928 (Percutaneous transcatheter placement of intracoronary stent[s], with coronary angioplasty when performed; single major coronary artery or branch) and +92929 (… each additional branch of a major coronary artery [List separately in addition to code for primary procedure]).

Note: Medicare bundles payment for the branch add-on codes into the major artery primary code, so you won’t see separate payment for the add-on code.