How To Use CPT Code 92928

CPT 92928 refers to the percutaneous transcatheter placement of intracoronary stent(s) with coronary angioplasty when performed for a single major coronary artery or branch. This article will cover the description, procedure, qualifying circumstances, when to use, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 92928.

1. What is CPT 92928?

CPT 92928 is a medical procedure code used to describe the percutaneous transcatheter placement of intracoronary stent(s) with coronary angioplasty when performed for a single major coronary artery or branch. This code is utilized by healthcare providers to accurately document and bill for this specific procedure.

2. 92928 CPT code description

The official description of CPT code 92928 is: “Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch.”

3. Procedure

The 92928 procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made in the brachial or femoral artery.
3. A guide wire is inserted through the incision.
4. A guide catheter is inserted over the guide wire and advanced through the vascular system until it reaches the opening of the coronary artery.
5. Dye is injected, and fluoroscopic images are taken to examine blood flow and catheter placement.
6. A balloon-tipped catheter is advanced into the stenosed area and inflated to flatten the plaque against the artery wall.
7. A balloon-mounted catheter with a stent is inserted into the stenosed site, and the balloon is expanded to fit the stent onto the artery wall.
8. Angioplasty may be performed to widen the vessel and improve blood flow.
9. All equipment is removed, hemostasis is achieved, and the wound is closed in layers.

4. Qualifying circumstances

Patients eligible to receive CPT code 92928 services are those with significant coronary artery stenosis, typically caused by atherosclerosis, that requires the placement of an intracoronary stent to restore blood flow. The procedure is indicated when conservative treatments, such as medication and lifestyle changes, have not been effective in managing the patient’s symptoms or when the patient is at high risk for complications from coronary artery disease.

5. When to use CPT code 92928

It is appropriate to bill the 92928 CPT code when the provider performs a percutaneous transcatheter placement of intracoronary stent(s) with coronary angioplasty, if performed, for a single major coronary artery or branch. This code should be used when the procedure is medically necessary and meets the qualifying circumstances outlined above.

6. Documentation requirements

To support a claim for CPT 92928, the following information should be documented in the patient’s medical record:

• Patient’s medical history and physical examination findings
• Diagnostic test results, such as coronary angiography, that confirm the presence of significant coronary artery stenosis
• Indications for the procedure, including the patient’s symptoms and the failure of conservative treatments
• Details of the procedure, including the specific artery or branch treated, the type and size of the stent(s) used, and any complications encountered
• Post-procedure care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 92928, it is essential to follow the appropriate guidelines and rules. Angioplasty, when performed, is included in this code and should not be reported separately. Additionally, if the provider performs percutaneous transluminal coronary lithotripsy, use code 0715T instead of 92928. Always ensure that the documentation requirements are met and that the procedure is medically necessary and meets the qualifying circumstances.

8. Historical information

CPT 92928 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Similar codes to CPT 92928

Five similar codes to CPT 92928 include:

• CPT 92920: This code is used for percutaneous transluminal coronary angioplasty without stent placement for a single major coronary artery or branch.
• CPT 92924: This code is used for percutaneous transluminal coronary atherectomy without stent placement for a single major coronary artery or branch.
• CPT 92933: This code is used for percutaneous transluminal coronary atherectomy with stent placement for a single major coronary artery or branch.
• CPT 92937: This code is used for percutaneous revascularization of coronary artery bypass graft with stent placement and angioplasty, if performed.
• CPT 92941: This code is used for percutaneous transluminal revascularization of acute total/subtotal occlusion during an acute myocardial infarction with stent placement and angioplasty, if performed.

10. Examples

Here are 10 detailed examples of CPT code 92928 procedures:

1. A 65-year-old patient with a history of angina undergoes percutaneous transcatheter placement of an intracoronary stent in the left anterior descending artery with angioplasty.
2. A 72-year-old patient with a history of myocardial infarction undergoes percutaneous transcatheter placement of an intracoronary stent in the right coronary artery with angioplasty.
3. A 58-year-old patient with a history of unstable angina undergoes percutaneous transcatheter placement of an intracoronary stent in the left circumflex artery with angioplasty.
4. A 69-year-old patient with a history of coronary artery disease undergoes percutaneous transcatheter placement of an intracoronary stent in the left main coronary artery with angioplasty.
5. A 62-year-old patient with a history of angina and previous coronary artery bypass grafting undergoes percutaneous transcatheter placement of an intracoronary stent in the saphenous vein graft to the right coronary artery with angioplasty.
6. A 75-year-old patient with a history of angina and diabetes undergoes percutaneous transcatheter placement of an intracoronary stent in the left anterior descending artery with angioplasty.
7. A 67-year-old patient with a history of angina and hypertension undergoes percutaneous transcatheter placement of an intracoronary stent in the right coronary artery with angioplasty.
8. A 71-year-old patient with a history of angina and hyperlipidemia undergoes percutaneous transcatheter placement of an intracoronary stent in the left circumflex artery with angioplasty.
9. A 64-year-old patient with a history of angina and previous percutaneous coronary intervention undergoes percutaneous transcatheter placement of an intracoronary stent in the left anterior descending artery with angioplasty.
10. A 76-year-old patient with a history of angina and chronic kidney disease undergoes percutaneous transcatheter placement of an intracoronary stent in the right coronary artery with angioplasty.