How To Use CPT Code 92978

CPT 92978 describes the endoluminal imaging of a coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention. 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 92978?

CPT 92978 can be used to describe the endoluminal imaging of a coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention. This code is used when the provider uses ultrasound or OCT to view the extent of blockage, placement of a stent, or other procedures on the heart before or after therapeutic intervention. The provider then interprets the images and reports the findings.

2. Official Description

The official description of CPT code 92978 is: ‘Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure).’ Notes: (Report 92978 once per session) (Use 92978 in conjunction with 92975, 92920, 92924, 92928, 92933, 92937, 92941, 92943, 93454 – 93461, 93563, 93564).

3. Procedure

1. In this procedure, the provider advances a catheter into a coronary vessel or previously placed graft using ultrasound or optical coherence tomography to view the extent of the blockage, placement of a stent, or other procedure on the heart before or after therapeutic intervention.
2. The provider then interprets the images obtained from the catheter to assess the structure and integrity of the vessel or graft and reports any abnormalities detected.

4. Qualifying circumstances

This procedure is performed when the patient requires diagnostic evaluation and/or therapeutic intervention on a coronary vessel or graft. The provider uses intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to visualize the vessel or graft. This procedure is typically performed in conjunction with other coronary therapeutic services and procedures.

5. When to use CPT code 92978

CPT code 92978 should be used when the provider performs endoluminal imaging of a coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention. This code should be reported once per session and in conjunction with other relevant codes for the primary procedure.

6. Documentation requirements

To support a claim for CPT code 92978, the provider must document the following information:

• Indication for the endoluminal imaging procedure
• Details of the imaging technique used (IVUS or OCT)
• Date and time of the procedure
• Interpretation of the images obtained
• Report of any abnormalities detected

7. Billing guidelines

When billing for CPT code 92978, ensure that the procedure is performed in conjunction with other relevant coronary therapeutic services and procedures. It is important to use the appropriate primary procedure code and report CPT code 92978 once per session. If reporting only the professional component or technical component, the appropriate modifiers should be appended to the code.

8. Historical information

CPT code 92978 was added to the Current Procedural Terminology system on January 1, 1997. The code underwent a change in description on January 1, 2017 to specify the use of intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during the procedure.

9. Examples

1. A cardiologist performs endoluminal imaging of a coronary vessel using intravascular ultrasound (IVUS) to assess the extent of blockage before performing percutaneous transluminal coronary angioplasty on a patient.
2. A cardiac surgeon uses optical coherence tomography (OCT) to visualize a previously placed graft and ensure its proper placement and functioning before performing a coronary artery bypass graft surgery.
3. An interventional radiologist performs endoluminal imaging of a coronary vessel using intravascular ultrasound (IVUS) to guide the placement of a stent during a percutaneous transluminal coronary angioplasty procedure.
4. A cardiovascular specialist uses optical coherence tomography (OCT) to assess the integrity of a coronary vessel after a stent placement procedure and reports any abnormalities detected.
5. A cardiac electrophysiologist performs endoluminal imaging of a coronary vessel using intravascular ultrasound (IVUS) to evaluate the effectiveness of an ablation procedure on a patient with arrhythmia.
6. A vascular surgeon uses optical coherence tomography (OCT) to visualize a previously placed graft and assess its patency and functioning in a patient with peripheral artery disease.
7. An interventional cardiologist performs endoluminal imaging of a coronary vessel using intravascular ultrasound (IVUS) to guide the placement of a drug-eluting stent during a percutaneous transluminal coronary angioplasty procedure.
8. A cardiac catheterization lab technician assists the provider in performing endoluminal imaging of a coronary vessel using intravascular ultrasound (IVUS) to assess the extent of blockage before a coronary artery bypass graft surgery.