Get the Details on FFR
Question: A patient’s records said they had a fractional flow reserve (FFR) as part of a stress test. Both a cardiologist and interventionalist were involved in the procedure, but the cardiologist performed the heart catheterization (cath) and the interventionalist performed the FFR. Can I code these separately since two different providers performed services? AAPC Forum Participant Answer: FFR is defined as intravascular Doppler velocity and/or pressure-derived coronary flow reserve measurement (coronary vessel or graft), which is used during coronary angiography, including pharmacologically induced stress. FFR is a measurement using a pressure guidewire during cardiac catheterizations and requires the vessel(s) to be documented and a finding/result for each vessel measured. CPT® codes +93571 (Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (List separately in addition to code for primary procedure)) and +93572 (… each additional vessel) are add-on codes to be used with primary codes. Since +93571/+93572 are add-on codes that require a primary code, in situations where the services are split between two different provider specialties, the billing of these services changes. Most commonly when a cardiologist or interventionalist is performing a cath, they will also perform the FFR themselves. In this scenario, the provider will bill both the cath code and FFR on the same claim. In some cases, like the one you describe, the cardiologist will perform the cath and then the interventionalist will perform the FFR separately. In these cases, instead of billing the FFR as +93571, the appropriate CPT® code would be 93799 (Unlisted cardiovascular service or procedure) and use +93571 as the comparable code for relative value unit (RVU) assignment. The only caveat to this is when both providers are in the same group and the exact same specialty; then, they may bill as one specialty and bill +93571 for the FFR. Cristin Robinson, CPC, CPMA, CCC, CRC, CEMC, AAPC Approved Instructor,
Education Coding Consultant, Bristol, Tennessee
