How To Use CPT Code 92938

CPT 92938 describes the percutaneous transluminal revascularization procedure performed on or through a coronary artery bypass graft. 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 92938?

CPT 92938 can be used to describe the percutaneous transluminal revascularization procedure performed on or through a coronary artery bypass graft. This code is used when the provider inserts a catheter with a rotating blade, inflates a balloon-tipped catheter into the blocked area of the coronary artery, and places a stent to expand the narrowed walls of the vessel to treat stenosis. CPT 92938 specifically describes work on each additional branch linked through a coronary artery bypass graft.

2. Official Description

The official description of CPT code 92938 is: ‘Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure).’ This code should be used in conjunction with CPT code 92937.

3. Procedure

1. During the procedure, the provider gains access to an additional branch linked through a coronary artery bypass graft.
2. The provider makes an incision into the brachial or femoral artery and inserts a guide wire through it.
3. A guide catheter is then inserted over the guide wire, moving it through the vascular system until it can be positioned at the opening into or through the coronary artery bypass graft.
4. The provider injects a dye and takes fluoroscopic images to examine the blood flow and placement of the catheter into the artery.
5. A distal protection device is placed into the vessel to prevent debris from moving into the rest of the circulatory system.
6. A catheter with a burr or other blade is advanced into the coronary vessel to destroy the material blocking the artery.
7. A balloon-tipped catheter is inserted into the stenosed area and inflated to flatten the plaque against the artery wall.
8. A balloon-mounted catheter with a stent is then inserted to the stenosed site. The balloon expands and fits the stent onto the wall of the artery.
9. The provider may also perform an angioplasty to widen the vessel.
10. Finally, the provider removes all the equipment, achieves hemostasis, and closes the wound in layers.