How To Use CPT Code 9007F

CPT 9007F describes a specific type of carotid stenosis that is indicated by an ipsilateral transient ischemic attack (TIA) or stroke occurring 120 or more days prior to a surgical procedure, or a prior contralateral carotid territory or vertebrobasilar TIA or stroke. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 9007F?

CPT 9007F is used to indicate a particular type of carotid stenosis, which is the narrowing of the carotid arteries that supply oxygen-rich blood to the brain. This code specifically applies to cases where the patient has experienced an ipsilateral TIA or stroke at least 120 days prior to a surgical procedure, or has a history of contralateral carotid territory or vertebrobasilar TIA or stroke.

2. Official Description

The official description of CPT code 9007F is: ‘Other carotid stenosis: Ipsilateral TIA or stroke 120 days or greater prior to procedure or any prior contralateral carotid territory or vertebrobasilar TIA or stroke (NMA-No Measure Associated)’

3. Procedure

1. In order to report CPT code 9007F, the provider must document that the patient has a specific type of carotid artery stenosis.
2. This stenosis must be evidenced by an ipsilateral TIA or stroke that occurred at least 120 days prior to the surgical procedure being reported, or a prior contralateral TIA or stroke originating in the arteries of the neck or base of the brain.

4. Qualifying circumstances

CPT code 9007F is used when the patient has a specific type of carotid stenosis. This can be indicated by either an ipsilateral TIA or stroke that occurred 120 or more days prior to a surgical procedure, or a history of contralateral carotid territory or vertebrobasilar TIA or stroke. There is currently no measure associated with this code.

5. When to use CPT code 9007F

CPT code 9007F should be used when the patient meets the qualifying circumstances described above. It is important to accurately document the patient’s history and the specific type of carotid stenosis in order to support the use of this code.

6. Documentation requirements

In order to support a claim for CPT code 9007F, the provider must document the following information:

• The patient’s diagnosis of carotid stenosis
• Evidence of an ipsilateral TIA or stroke occurring 120 or more days prior to the surgical procedure, or a history of contralateral carotid territory or vertebrobasilar TIA or stroke

7. Billing guidelines

When reporting CPT code 9007F, it is important to ensure that the patient meets the qualifying circumstances described above. This code should not be reported if other specific carotid stenosis codes (9001F-9006F) have already been used for the same patient within the same time period. It is also important to follow any additional billing guidelines provided by the payer or relevant coding guidelines.

8. Historical information

CPT code 9007F was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient who had an ipsilateral TIA 150 days prior to a carotid endarterectomy procedure.
2. A patient with a history of contralateral carotid territory TIA who is scheduled for a carotid angioplasty.
3. A patient who experienced a vertebrobasilar stroke in the past and is now undergoing a carotid artery stenting procedure.
4. A patient who had an ipsilateral TIA 200 days prior to a carotid artery bypass surgery.
5. A patient with a history of contralateral carotid territory TIA who is undergoing a carotid artery patch angioplasty.
6. A patient who experienced a vertebrobasilar stroke in the past and is now scheduled for a carotid endarterectomy.
7. A patient who had an ipsilateral TIA 180 days prior to a carotid artery balloon angioplasty.
8. A patient with a history of contralateral carotid territory TIA who is undergoing a carotid artery stenting and angioplasty procedure.
9. A patient who experienced a vertebrobasilar stroke in the past and is now scheduled for a carotid artery bypass surgery.
10. A patient who had an ipsilateral TIA 250 days prior to a carotid artery patch angioplasty.