How To Use CPT Code 92943

CPT 92943 describes the percutaneous transluminal revascularization procedure for chronic total occlusion of a coronary artery, coronary artery branch, or 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 92943?

CPT 92943 is used to describe a percutaneous transluminal revascularization procedure for chronic total occlusion of a coronary artery, coronary artery branch, or coronary artery bypass graft. This procedure involves the insertion of a catheter with a rotating blade to remove the material blocking the artery. A balloon-tipped catheter may also be used to open the narrowed walls of the vessel, and a stent may be placed to keep the artery open.

2. Official Description

The official description of CPT code 92943 is: ‘Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel.’

3. Procedure

1. In this procedure, the provider makes an incision into 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. The provider injects a dye and takes fluoroscopic images 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 may also be inserted to the coronary occlusion to widen the vessel.
6. A stent may be inserted to keep the artery open, and the balloon expands to fit the stent on the wall of the artery.
7. The provider may also perform an angioplasty to further widen the vessel.
8. Finally, all equipment is removed, hemostasis is achieved, and the wound is closed.

4. Qualifying circumstances

CPT 92943 is performed on patients with chronic total occlusion of a coronary artery, coronary artery branch, or coronary artery bypass graft. The procedure is used to restore blood flow in a single blocked vessel. The patient must meet the criteria for the procedure, and the provider must determine that the benefits of the procedure outweigh the risks.

5. When to use CPT code 92943

CPT code 92943 should be used when a provider performs a percutaneous transluminal revascularization procedure for chronic total occlusion of a coronary artery, coronary artery branch, or coronary artery bypass graft. This code is specifically for a single vessel. If the procedure involves multiple vessels, a different code should be used.

6. Documentation requirements

To support a claim for CPT 92943, the provider must document the following information:

• Patient’s diagnosis of chronic total occlusion
• Specific vessels or grafts involved in the procedure
• Details of the procedure, 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
• Any complications or adverse events that occurred during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 92943, ensure that the procedure meets the criteria for chronic total occlusion of a coronary artery, coronary artery branch, or coronary artery bypass graft. Use the appropriate CPT code based on the number of vessels involved in the procedure. It is important to follow the specific guidelines provided by the payer to ensure accurate and timely reimbursement.

8. Historical information

CPT 92943 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 revascularization procedure for chronic total occlusion of a single coronary artery in a patient with a history of myocardial infarction.
2. A patient with chronic total occlusion of a coronary artery branch undergoes a percutaneous transluminal revascularization procedure using a rotating blade and a stent to restore blood flow.
3. A provider performs a percutaneous transluminal revascularization procedure for chronic total occlusion of a coronary artery bypass graft in a patient with angina.