How To Use CPT Code 93592

CPT 93592 describes the percutaneous transcatheter closure of paravalvular leak by inserting an additional occlusion device. 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 93592?

CPT 93592 can be used to describe the percutaneous transcatheter closure of paravalvular leak by inserting an additional occlusion device. This code is used when the provider needs to close a leak around the mitral or aortic valve using a catheter inserted percutaneously. The additional occlusion device is inserted to complete the closure of the leak.

2. Official Description

The official description of CPT code 93592 is: ‘Percutaneous transcatheter closure of paravalvular leak; each additional occlusion device (List separately in addition to code for primary procedure).’ This code should be used in conjunction with either CPT code 93590 for the initial occlusion device for the mitral valve or CPT code 93591 for the initial occlusion device for the aortic valve.

3. Procedure

  1. The provider advances a new catheter through the sheath toward the defect in the valve.
  2. Using imaging guidance, the provider positions the catheter in the area of the leak.
  3. An occluding device is inserted through the sheath and secured in place to close off the leak.
  4. If the procedure is for a mitral valve leak, pressure is applied over the percutaneous incision site to achieve hemostasis.
  5. The provider administers protamine to reverse the effects of heparin.
  6. Imaging guidance is used to confirm closure, remove all instruments, check for bleeding, and close the incision.

4. Qualifying circumstances

CPT 93592 is used when an initial occlusion device has been inserted but did not completely close off the mitral or aortic valve leak. The procedure is performed before the administration of protamine and requires imaging guidance. The provider must use a new catheter and an additional occlusion device to complete the closure of the leak.

5. When to use CPT code 93592

CPT code 93592 should be used when an additional occlusion device is inserted to close a paravalvular leak around the mitral or aortic valve. It is important to report this code in conjunction with the appropriate primary procedure code (93590 for the mitral valve or 93591 for the aortic valve). This code should not be reported if the leak is successfully closed with the initial occlusion device.

6. Documentation requirements

To support a claim for CPT 93592, the provider must document the following information:

  • Confirmation of the need for an additional occlusion device
  • Details of the procedure, including the use of imaging guidance
  • Date and time of the procedure
  • Specific occlusion device used
  • Administration of protamine
  • Confirmation of closure and absence of bleeding

7. Billing guidelines

When billing for CPT 93592, ensure that the procedure meets the qualifying circumstances and is performed in conjunction with the appropriate primary procedure code (93590 or 93591). It is important to check with the payer for any specific reporting requirements, including the possibility of reporting imaging guidance separately.

8. Historical information

CPT 93592 was added to the Current Procedural Terminology system on January 1, 2017. There have been no updates to the code since its addition.

9. Examples

  1. A provider inserts an additional occlusion device to close a paravalvular leak around the mitral valve.
  2. Using imaging guidance, a provider positions a catheter in the area of an aortic valve leak and inserts an additional occlusion device to complete the closure.
  3. After the initial occlusion device fails to completely close off a mitral valve leak, a provider advances a new catheter and inserts an additional occlusion device to achieve closure.
  4. A provider inserts an additional occlusion device to close a paravalvular leak around the aortic valve.
  5. Using imaging guidance, a provider positions a catheter in the area of a mitral valve leak and inserts an additional occlusion device to complete the closure.
  6. After the initial occlusion device fails to completely close off an aortic valve leak, a provider advances a new catheter and inserts an additional occlusion device to achieve closure.
  7. A provider inserts an additional occlusion device to close a paravalvular leak around the mitral valve.
  8. Using imaging guidance, a provider positions a catheter in the area of an aortic valve leak and inserts an additional occlusion device to complete the closure.
  9. After the initial occlusion device fails to completely close off a mitral valve leak, a provider advances a new catheter and inserts an additional occlusion device to achieve closure.
  10. A provider inserts an additional occlusion device to close a paravalvular leak around the aortic valve.

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