How To Use CPT Code 92979

CPT 92979 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 92979?

CPT 92979 can be used to report 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 an add-on procedure that is used when the provider advances a catheter into an additional coronary vessel or previously placed graft after the initial vessel using ultrasound or OCT to view the extent of the blockage, placement of a stent, or other procedure 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 92979 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; each additional vessel (List separately in addition to code for primary procedure).’ Notes: (Report 92979 once per additional vessel) (Use 92979 in conjunction with 92978) (Intravascular ultrasound and optical coherence tomography services include all transducer manipulations and repositioning within the specific vessel being examined, both before and after therapeutic intervention [eg, stent placement]).

3. Procedure

1. In this add-on procedure, the provider advances a catheter into an additional coronary vessel or previously placed graft after the initial vessel using ultrasound or OCT 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 ultrasound or OCT to assess the structure and integrity of the vessel or graft and reports any abnormality detected.

4. Qualifying circumstances

CPT 92979 is typically performed when the patient is appropriately prepped and anesthetized for a separate diagnostic or therapeutic procedure and after intravascular ultrasound (IVUS) or optical coherence tomography (OCT) of an initial vessel. The provider incises another coronary vessel and inserts a guidewire through it. They advance a catheter fitted with an ultrasound probe or optical coherence transducer into the vessel to the area to be examined. The provider further advances the catheter to obtain images of the interior of the coronary vessel or graft. This procedure is performed to assess the structure and integrity of the vessel or graft and to detect any abnormalities.

5. When to use CPT code 92979

CPT code 92979 should be used when the provider performs endoluminal imaging of an additional coronary vessel or previously placed graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention. This code should be reported once per additional vessel and should be used in conjunction with the primary procedure code for the imaging of the initial vessel (CPT code 92978).

6. Documentation requirements

To support a claim for CPT code 92979, the provider must document the following information:

• Details of the procedure performed, including the use of intravascular ultrasound (IVUS) or optical coherence tomography (OCT)
• Specific vessel or graft examined
• Images obtained and their interpretation
• Any abnormalities detected
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 92979, ensure that the procedure meets the qualifying circumstances and is performed as an add-on to the imaging of the initial vessel (CPT code 92978). If reporting only the professional component, append modifier 26 to the code. If reporting only the technical component, append modifier TC to the code unless the hospital provided the technical component. Do not append a professional or technical modifier when reporting a global service in which one provider renders both components.

8. Historical information

CPT code 92979 was added to the Current Procedural Terminology system on January 1, 1997. The code underwent a change on January 1, 2017, with an updated description and additional notes.

9. Examples

1. A cardiologist performs endoluminal imaging of an additional coronary vessel using intravascular ultrasound (IVUS) to assess the extent of a blockage before performing a stent placement procedure.
2. An interventional radiologist uses optical coherence tomography (OCT) to image a previously placed graft and interpret the images to assess its integrity and detect any abnormalities.
3. A cardiac surgeon performs endoluminal imaging of an additional coronary vessel using intravascular ultrasound (IVUS) during a diagnostic evaluation to determine the need for a bypass graft procedure.
4. An interventional cardiologist uses optical coherence tomography (OCT) to guide the placement of a stent in an additional coronary vessel and interprets the images to ensure proper positioning.