Cardiology Coding Alert

Reader Questions:

Documentation Must Specify Certain Details for CTO

Question: My cardiologist made an incision into the patient’s femoral artery and inserted a guidewire through it. They then inserted a guide catheter over the guidewire, moving it through the vascular system until they positioned the catheter at the opening to the coronary artery. My cardiologist injected a dye and took fluoroscopic images to examine the blood flow and placement of catheter into the artery. They then advanced a catheter with a burr into the coronary vessel to destroy the material blocking the artery. How should I report this?

Oregon Subscriber

Answer: Report 92943 (Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel) on your claim.

Coding tip: The physician’s documentation for chronic total occlusion needs to specify both “chronic” and “total” for you to appropriately report this code. Chronic total occlusion (CTO) is a complete or nearly complete blockage of one or more coronary arteries. The CTO usually lasts three months or longer.