Cardiology Coding Alert

Question: The doctor performed an LHC and used OCT of the LAD (30 to 40 percent plaque). How should I code the OCT?

Codify Member

Answer: The appropriate codes for OCT (optical coherence tomography) performed in 2012 are the following:

• +0291T, Intravascular optical coherence tomography (coronary native vessel or graft) during diagnostic evaluation and/or therapeutic intervention, including imaging supervision, interpretation, and report; initial vessel (List separately in addition to primary procedure)
• +0292T, ... each additional vessel (List separately in addition to primary procedure).

OCT is a catheter-based imaging method that produces high-resolution images using light. Physicians can view the insides of arteries including stents. According to guidelines with the codes, intravascular OCT includes "all transducer manipulations and repositioning within the specific vessel being examined, both before and after therapeutic intervention [e.g., stent placement])."

Don't forget: Report the primary service including the left heart catheterization (LHC), as well. CPT® guidelines instruct you to report +0291T in addition to the following primary codes:

• 92975, Thrombolysis, coronary ...
• 92980, Transcatheter placement of an intracoronary stent(s) ...
• 92982, Percutaneous transluminal coronary balloon angioplasty ...
• 92995, Percutaneous transluminal coronary atherectomy ...
• 93454-93461, Catheter placement in coronary artery(s) for coronary angiography ...
• 93563-93564, Injection procedure during cardiac catheterization ...

A note with +0292T indicates you should report that code with +0291T.

Tip: Review payer guidelines for clarification before performing OCT. Some payers consider +0291T and +0292T investigational.