How To Use CPT Code 0523T

CPT 0523T describes the intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree. This article will cover the description, official definition, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 0523T?

CPT 0523T can be used to describe the intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree. This code is used when a provider reviews and interprets, in real time during a cardiac catheterization procedure, the results of an imaging procedure that maps the blood flow in the coronary arteries using 3D color mapping to determine whether intervention is needed for coronary stenosis.

2. Official Description

The official description of CPT code 0523T is: ‘Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure).’ It is important to note that this code should be used in conjunction with specific primary procedure codes and should not be reported more than once per session. It should also not be reported with certain other codes.

3. Procedure

1. During a cardiac catheterization procedure, the provider inserts a catheter into a major vessel and advances it to the heart.
2. After obtaining an angiogram, the provider enters the patient’s mean aortic pressure and possibly other hemodynamic data into a computer displaying the angiographic data.
3. The computer uses proprietary software/algorithm to generate a complete three-dimensional (3D) coronary tree of the left or right coronary system.
4. The computer scans the entire 3D tree and examines each branch and bifurcation for narrowing of the arterial lumen.
5. The fractional flow reserve (FFR) values at each point along the vessels are color-coded and superimposed on the 3D model.
6. The provider reviews the color-coded FFR values in real time to determine whether intervention is needed for coronary stenosis.

4. Qualifying circumstances

CPT 0523T is used when a provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree. This procedure is typically performed during a cardiac catheterization procedure to assess the blood flow in the coronary arteries and determine if intervention is necessary for coronary stenosis. It is important to note that this code should be used in conjunction with specific primary procedure codes and should not be reported with certain other codes.

5. When to use CPT code 0523T

CPT code 0523T should be used when a provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree during a cardiac catheterization procedure. It is important to use this code in conjunction with the appropriate primary procedure codes and to follow the guidelines regarding reporting with other codes.

6. Documentation requirements

To support a claim for CPT code 0523T, the provider must document the following information:

• Details of the cardiac catheterization procedure
• Results of the angiogram and hemodynamic data
• Specific software/algorithm used for generating the 3D coronary tree
• Color-coded FFR values and their interpretation
• Any interventions performed based on the FFR values
• Signature of the provider

7. Billing guidelines

When billing for CPT code 0523T, ensure that the procedure is performed during a cardiac catheterization procedure and that the appropriate primary procedure codes are also reported. It is important to follow the guidelines regarding reporting with other codes and to avoid reporting this code more than once per session. The documentation should support the medical necessity and appropriateness of using this code.

8. Historical information

CPT code 0523T was added to the Current Procedural Terminology system on January 1, 2019. There have been no updates to the code since its addition.

9. Examples

1. A provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree during a cardiac catheterization procedure to determine the need for intervention in a patient with suspected coronary stenosis.
2. During a cardiac catheterization procedure, a provider reviews the results of an imaging procedure that maps the blood flow in the coronary arteries using 3D color mapping and interprets the color-coded FFR values to determine whether intervention is needed for coronary stenosis.
3. A patient undergoes a cardiac catheterization procedure, and the provider uses intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree to assess the blood flow and determine the need for intervention in cases of possible coronary stenosis.
4. During a cardiac catheterization procedure, a provider utilizes 3D functional mapping of color-coded FFR values for the coronary tree to evaluate the blood flow in the coronary arteries and make real-time decisions regarding possible interventions for coronary stenosis.
5. A patient undergoes a cardiac catheterization procedure, and the provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree to assess the severity of coronary stenosis and determine the need for intervention.
6. During a cardiac catheterization procedure, a provider uses 3D functional mapping of color-coded FFR values for the coronary tree to evaluate the blood flow in the coronary arteries and determine whether intervention is necessary for coronary stenosis.
7. A patient undergoes a cardiac catheterization procedure, and the provider reviews the results of an imaging procedure that maps the blood flow in the coronary arteries using 3D color mapping. The provider interprets the color-coded FFR values in real time to make decisions regarding possible interventions for coronary stenosis.
8. During a cardiac catheterization procedure, a provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree to assess the blood flow and determine the need for intervention in cases of suspected coronary stenosis.
9. A patient undergoes a cardiac catheterization procedure, and the provider utilizes 3D functional mapping of color-coded FFR values for the coronary tree to evaluate the blood flow in the coronary arteries and make real-time decisions regarding possible interventions for coronary stenosis.
10. During a cardiac catheterization procedure, a provider performs intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree to assess the severity of coronary stenosis and determine the need for intervention.