Radiology Coding Alert

READER QUESTIONS:

Expect Denial for 92973 Reported Alone

Question: Can I use CPT 92973 to report an AngioJet performed without PTCA or stent?


South Carolina Subscriber


Answer: No. Your physician has to provide a stent or PTCA to report +92973 (Percutaneous transluminal coronary thrombectomy [list separately in addition to code for primary procedure]).
 
Code 92973 must be used in conjunction with the following codes, according to a note in the CPT book:

• 92980--Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel

• 92982--Percutaneous transluminal coronary balloon angioplasty; single vessel. Code 92973 is an add-on code, which means it "describes additional intra-service work associated with the primary procedure." You must never report an add-on code as a stand-alone code, according to CPT guidelines. Your CPT manual may point out add-on codes with a "+" symbol.

Payers generally won't allow payment for AngioJet if 92980 or 92982 isn't on the claim, but you may try using an unlisted-procedure code, such as 76499 (Unlisted diagnostic radiographic procedure) or 93799 (Unlisted cardiovascular service or procedure). Request reimbursement equivalent to 92975 (Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography). Be sure to include sufficient justification in your documentation.

Note: AngioJet is a brand name for a mechanical thrombectomy device.
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