How To Use CPT Code 92986

CPT 92986 describes the percutaneous balloon valvuloplasty procedure for the aortic valve. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92986?

CPT 92986 is used to describe the percutaneous balloon valvuloplasty procedure for the aortic valve. This procedure involves the use of a balloon catheter to open up a stenotic aortic valve, allowing blood to flow more freely. The provider makes an incision in the femoral artery, or rarely in the brachial or subclavian artery, and inserts a guidewire through it. The balloon catheter is then advanced over the guidewire into the stenosed aortic valve under imaging guidance. The provider inflates the balloon using a saline solution, which opens the valve, and then deflates it by withdrawing the solution. After obtaining angiographic images to confirm the success of the procedure, the provider removes all the equipment, stops the bleeding, and closes the incision.

2. Official Description

The official description of CPT code 92986 is: ‘Percutaneous balloon valvuloplasty; aortic valve.’

3. Procedure

1. The provider makes an incision in the femoral artery, or rarely in the brachial or subclavian artery, and inserts a guidewire through it.
2. A balloon catheter is advanced over the guidewire into the stenosed aortic valve under imaging guidance.
3. The provider obtains angiographic images to confirm the position of the balloon catheter.
4. The provider inflates the balloon using a saline solution, which opens the stenosed aortic valve.
5. The provider deflates the balloon by withdrawing the saline solution.
6. The provider removes all the equipment, stops the bleeding, and closes the incision.

4. Qualifying circumstances

CPT 92986 is performed on patients with a stenotic aortic valve. The procedure is appropriate for patients who have a narrowing of the aortic valve, which affects its ability to open and close properly. The provider must use a balloon catheter to open the valve, and the procedure must be performed percutaneously. The patient must be appropriately prepped and anesthetized, and the provider must have the necessary imaging guidance to perform the procedure safely and effectively.

5. When to use CPT code 92986

CPT code 92986 should be used when a provider performs percutaneous balloon valvuloplasty specifically on the aortic valve. It should not be used for valvuloplasty procedures on other valves, such as the mitral or pulmonary valves. If the documentation refers to valvuloplasty of the mitral valve, use CPT code 92987. For valvuloplasty of the pulmonary valve, use CPT code 92990.

6. Documentation requirements

To support a claim for CPT code 92986, the provider must document the following information:

• Patient’s diagnosis of a stenotic aortic valve
• Details of the procedure, including the use of a balloon catheter and imaging guidance
• Date of the procedure
• Start and end time of the procedure
• Angiographic images obtained during the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 92986, ensure that the procedure is performed specifically on the aortic valve. Do not report CPT code 92986 for valvuloplasty procedures on other valves. It is important to accurately document the details of the procedure and any complications or additional procedures performed. CPT code 92986 should not be reported with other codes for valvuloplasty procedures on different valves. It is important to review the documentation and select the appropriate code based on the specific valve being treated.

8. Historical information

CPT code 92986 was added to the Current Procedural Terminology system on January 1, 1992. There have been no updates to the code since its addition.

9. Examples

1. A provider performs percutaneous balloon valvuloplasty on a patient with a stenotic aortic valve.
2. A patient undergoes percutaneous balloon valvuloplasty for the treatment of a narrowed aortic valve.
3. A provider uses a balloon catheter to open up a stenotic aortic valve during a percutaneous valvuloplasty procedure.
4. A patient with a stenotic aortic valve undergoes a percutaneous balloon valvuloplasty to improve blood flow.
5. A provider performs a percutaneous valvuloplasty procedure specifically on the aortic valve to treat a stenotic condition.
6. A patient with a narrowed aortic valve receives percutaneous balloon valvuloplasty to alleviate symptoms and improve cardiac function.
7. A provider successfully performs percutaneous balloon valvuloplasty on a patient with a stenotic aortic valve, restoring proper valve function.
8. A patient undergoes a percutaneous valvuloplasty procedure on the aortic valve to relieve obstruction and improve blood flow.
9. A provider uses a balloon catheter to open up a stenotic aortic valve, improving the patient’s cardiac function.
10. A patient with a stenotic aortic valve receives percutaneous balloon valvuloplasty as a less invasive alternative to surgical intervention.