How To Use CPT Code 92933

CPT 92933 describes the percutaneous transluminal coronary atherectomy procedure, which involves the use of a catheter with a rotating blade to remove plaque from a blocked coronary artery. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92933?

CPT 92933 is a code used to describe a specific procedure called percutaneous transluminal coronary atherectomy. This procedure involves the insertion of a catheter with a rotating blade into a blocked coronary artery. The provider then inflates a balloon-tipped catheter to open the narrowed walls of the vessel and places a stent to keep the artery open. This code specifically applies to work done on a single major coronary artery or branch.

2. Official Description

The official description of CPT code 92933 is: ‘Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch.’

3. Procedure

1. The provider makes an incision in the brachial or femoral artery and inserts a guide wire through it.
2. A guide catheter is then inserted over the guide wire and positioned at the opening to the coronary artery.
3. A dye is injected, and fluoroscopic images are taken to examine the blood flow and placement of the catheter.
4. A catheter with a rotating blade is advanced into the coronary vessel to remove the material blocking the artery.
5. A balloon-tipped catheter is inserted into the coronary lesion and inflated to flatten the plaque against the artery wall.
6. A balloon-mounted catheter with a stent is then inserted to the stenosed site, and the balloon is expanded to fit the stent on the wall of the artery.
7. If necessary, the provider may also perform an angioplasty to widen the vessel.
8. All equipment is removed, hemostasis is achieved, and the wound is closed.

4. Qualifying circumstances

CPT 92933 is used for patients who have a blocked coronary artery and require treatment to remove plaque and open the narrowed vessel. The procedure is performed by a provider who inserts a catheter with a rotating blade, inflates a balloon-tipped catheter, and places a stent to expand the narrowed walls of the artery. This code specifically applies to work done on a single major coronary artery or branch.

5. When to use CPT code 92933

CPT code 92933 should be used when a provider performs percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty on a single major coronary artery or branch. This code should not be used for procedures involving multiple arteries or branches.

6. Documentation requirements

To support a claim for CPT 92933, the provider must document the following information:

• Patient’s diagnosis and the need for percutaneous transluminal coronary atherectomy
• Specific details of the procedure performed, including the use of a rotating blade, balloon-tipped catheter, and stent
• Date and duration of the procedure
• Fluoroscopic images showing the placement of the catheter and the blood flow in the coronary artery
• Any additional procedures performed, such as angioplasty
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 92933, ensure that the procedure meets the criteria for this code, including the use of a rotating blade, balloon-tipped catheter, and stent placement on a single major coronary artery or branch. Do not report CPT 92933 if the provider performs angioplasty separately. Follow the appropriate coding guidelines and modifiers for accurate billing.

8. Historical information

CPT 92933 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 percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty on a single major coronary artery in a patient with severe stenosis.
2. A patient with a blocked coronary artery undergoes percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty on a branch of the artery to improve blood flow.
3. A provider performs percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty on a single major coronary artery in a patient with unstable angina.
4. A patient with a narrowed coronary artery undergoes percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty to alleviate symptoms of chest pain.
5. A provider performs percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty on a branch of a major coronary artery in a patient with a history of myocardial infarction.
6. A patient with a blocked coronary artery undergoes percutaneous transluminal coronary atherectomy with intracoronary stent placement and coronary angioplasty to prevent further complications.