How To Use CPT Code 92925

CPT 92925 describes the percutaneous transluminal coronary atherectomy procedure, which involves the use of a catheter with a rotating blade and a balloon-tipped catheter to treat stenosis in each additional branch of a major coronary artery. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92925?

CPT 92925 is used to describe a percutaneous transluminal coronary atherectomy procedure that involves the use of a catheter with a rotating blade and a balloon-tipped catheter to treat stenosis in each additional branch of a major coronary artery. This code is used when the provider performs the atherectomy and possible angioplasty for a single major coronary artery or branch, and gains access to an additional branch of a major coronary artery during the same session.

2. Official Description

The official description of CPT code 92925 is: ‘Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure).’ This code should be used in conjunction with other codes such as 92924, 92928, 92933, 92937, 92941, and 92943.

3. Procedure

1. During the procedure, the provider gains access to an additional branch of a major coronary artery.
2. An incision is made in the brachial or femoral artery, and a guide wire is inserted through it.
3. A guide catheter is then inserted over the guide wire and positioned at the opening to the coronary artery.
4. A dye is injected, and fluoroscopic images are taken to examine the blood flow and placement of the catheter.
5. A catheter with a rotating blade is advanced into the coronary vessel to remove the material blocking the arteries.
6. A balloon-tipped catheter is also inserted into the stenosed area and inflated to flatten the plaque against the artery wall, allowing for the removal of the plaque.
7. If necessary, the provider may also perform an angioplasty to widen the vessel.
8. After the procedure, all equipment is removed, hemostasis is achieved, and the wound is closed.

4. Qualifying circumstances

CPT 92925 is performed on patients with stenosis in each additional branch of a major coronary artery. The procedure is typically done in conjunction with a primary procedure on a single major coronary artery or branch. The provider must have appropriate access to the additional branch and use the necessary equipment, such as a catheter with a rotating blade and a balloon-tipped catheter, to treat the stenosis.

5. When to use CPT code 92925

CPT code 92925 should be used when the provider performs a percutaneous transluminal coronary atherectomy procedure with a rotating blade and a balloon-tipped catheter to treat stenosis in each additional branch of a major coronary artery. This code should be reported in addition to the primary procedure code for the treatment of the single major coronary artery or branch.

6. Documentation requirements

To support a claim for CPT 92925, the provider must document the following information:

• Details of the primary procedure performed on the single major coronary artery or branch
• Specific details of the atherectomy procedure performed on each additional branch of a major coronary artery
• Documentation of the access gained to the additional branch
• Fluoroscopic images showing the placement of the catheter and the blood flow in the coronary artery
• Details of any angioplasty performed, if applicable
• Documentation of the removal of equipment, achievement of hemostasis, and closure of the wound

7. Billing guidelines

When billing for CPT 92925, ensure that the procedure is performed on each additional branch of a major coronary artery and that the necessary equipment, such as a catheter with a rotating blade and a balloon-tipped catheter, is used. This code should be reported in addition to the primary procedure code for the treatment of the single major coronary artery or branch. It is important to note that payers will not reimburse for CPT 92925 if it is reported without an appropriate primary code for the repair procedure on a single major coronary artery.

8. Historical information

CPT 92925 was added to the Current Procedural Terminology system on January 1, 2013. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a percutaneous transluminal coronary atherectomy procedure with a rotating blade and a balloon-tipped catheter to treat stenosis in each additional branch of a major coronary artery during the same session as the primary procedure on a single major coronary artery.
2. During a cardiac catheterization, the provider gains access to an additional branch of a major coronary artery and performs a percutaneous transluminal coronary atherectomy procedure with a rotating blade and a balloon-tipped catheter to treat stenosis.