How To Use CPT Code 92990

CPT 92990 describes the percutaneous balloon valvuloplasty procedure for the pulmonary valve. 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 92990?

CPT 92990 can be used to describe the percutaneous balloon valvuloplasty procedure performed on the pulmonary valve. This code is used when a healthcare provider opens a stenotic pulmonary valve using a balloon catheter. The procedure involves inflating and deflating the balloon to flatten the deposition of plaque in the valve, thus improving its ability to open and close properly.

2. Official Description

The official description of CPT code 92990 is: ‘Percutaneous balloon valvuloplasty; pulmonary valve.’

3. Procedure

1. The healthcare provider makes an incision in the brachial or femoral vein.
2. A guidewire is inserted through the incision and advanced up to the blocked pulmonary valve under image guidance.
3. A balloon catheter is then inserted and positioned in the pulmonary artery.
4. The provider inflates the balloon using a saline solution, which flattens the deposition of plaque in the valve.
5. The balloon is then deflated by withdrawing the saline solution.
6. All equipment is removed, and the incision is closed.

4. Qualifying circumstances

CPT 92990 is performed on patients with a stenotic pulmonary valve. The procedure is appropriate when the valve becomes stiff, affecting its ability to open and close properly. It is important to note that CPT 92990 specifically refers to valvuloplasty of the pulmonary valve. For valvuloplasty of the aortic valve, use CPT code 92986, and for valvuloplasty of the mitral valve, use CPT code 92987.

5. When to use CPT code 92990

CPT code 92990 should be used when a healthcare provider performs percutaneous balloon valvuloplasty on the pulmonary valve. It is important to ensure that the documentation specifies the procedure performed on the pulmonary valve and not on other valves.

6. Documentation requirements

To support a claim for CPT 92990, the healthcare provider must document the following information:

• Patient’s diagnosis of a stenotic pulmonary valve
• Description of the procedure performed, including the use of a balloon catheter
• Date of the procedure
• Details of the incision site (brachial or femoral vein)
• Confirmation of image guidance used during the procedure
• Angiographic images obtained during the procedure
• Details of the balloon inflation and deflation process
• Confirmation of the removal of all equipment
• Documentation of wound closure

7. Billing guidelines

When billing for CPT 92990, ensure that the procedure performed is specifically on the pulmonary valve. It is important to note that CPT 92990 should not be reported with other codes such as CPT codes 92966 to 92968, which are used for other cardiovascular services and procedures. It is also important to consider the location of the testing when coding for pulmonary function tests (PFTs), as they have both a professional and technical component.

8. Historical information

CPT 92990 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 cardiologist performs percutaneous balloon valvuloplasty on a patient with a stenotic pulmonary valve.
2. A cardiac surgeon uses a balloon catheter to open a blocked pulmonary valve in a pediatric patient.
3. An interventional radiologist performs percutaneous balloon valvuloplasty on the pulmonary valve of a patient with congenital heart disease.
4. A cardiovascular specialist performs the procedure on an elderly patient with a stenotic pulmonary valve to improve their heart function.
5. A team of healthcare providers performs percutaneous balloon valvuloplasty on the pulmonary valve of a patient with a history of rheumatic heart disease.
6. A cardiac catheterization lab performs the procedure on a patient with a stenotic pulmonary valve as part of their treatment plan.
7. An interventional cardiologist performs percutaneous balloon valvuloplasty on the pulmonary valve of a patient with pulmonary valve stenosis.
8. A pediatric cardiologist performs the procedure on an infant with a congenital heart defect affecting the pulmonary valve.
9. A cardiovascular surgeon performs percutaneous balloon valvuloplasty on the pulmonary valve of a patient with a history of endocarditis.
10. An interventional radiologist performs the procedure on a patient with a stenotic pulmonary valve to relieve their symptoms and improve their quality of life.