Question Coronary Shockwave Lithotripsy - CPT code?

vidraj

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Hello everyone,

Need opinion with CPT code for the interventional procedure below.



Procedure note:
The right radial artery was accessed via Seldinger technique, 6-French sheath was introduced. A 6-French EBU 3.75 guide was used to cannulate left main. Diagnostic angiography reveals patent left main at the ostium, body and the bifurcation.
Left anterior descending artery had a mid long 80% calcific lesion in a type 2 vessel with a quick taper off of the LAD beyond the apical diagonal.
BMW wire was advanced through the lesion with ease and parked into the apical LAD. The lesion was directly subjected to an intravascular lithotripsy using a shockwave device, 2.5 x 12 balloon at 2 atmospheres with 10 cycles of shock wave done twice in sequence through the length of the lesion without complications. Lesion opened up very smoothly. Lesion was then subjected to a direct stenting using a 2.75 x 26 Onyx drug-eluting stent and deployed at 22 atmospheres with good distal apposition. The stent was then post dilated with a 3.0 NC balloon in the mid and distal parts with adequate stent apposition to the arterial walls. There was haziness in the proximal part of the stent at the bend of the artery and hence another 3.5 x 8 Onyx drug-eluting stent was deployed in overlapping manner at 16 atmospheres and post-dilated at 14 atmospheres in the overlapping segment with excellent angiographic results without complications. The patient tolerated the procedure well.
325 mg of aspirin and 300 mg of additional Plavix was given on the day of the procedure post angioplasty. ACT was monitored throughout the case as needed. Heparin was given for anticoagulation.
Procedure was completed without complications.
CONCLUSIONS: Successful shock wave lithotripsy and angioplasty with stent deployment in the mid LAD using a 2.75 stent as well as a 3.5 stent in overlapping manner with excellent angiographic results without complications.



I couldn't find a specific CPT CODE for Coronary Shockwave Lithotripsy.

- Can we consider this as Atherectomy and code it as 92933 - LD ?
Or
- is this considered part of angioplasty and code as 92928 - LD Only?

TIA
Vid.
 
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cpc2007

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Hello - if you are coding professional charges for the cardiologist, there is no separate code for the coronary shockwave lithotripsy. The lithotripsy is not the same as an atherectomy so it shouldn't be coded as such. You would code the most extensive intervention in the vessel as normal (in this case the stent placement).
If you are coding for an outpatient hospital, you can use C1761 for the lithotripsy. There were some issues I think when CMS was determining which codes in the C960x series could be reported with C1761, but last I heard many consultants and professional societies were appealing to CMS to review their guidance for outpatient hospital reporting.

I hope that helps!

Kim
www.codingmastery.com
 
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Please see MLN #- MM12316 - effective July 2021.

See page 4 of 8 - It states that C1761 is not to be coded, but to use 92928 for the professional services for lithotripsy.
 
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What HCPCS code is everyone using when a coronary IVL is done? Should C1725 be used instead of C1761? Is anyone else running into device edits when the physcian goes off label with the IVL catheter?
 

ldickerson58

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I am new to coding the shockwave coronary IVL and was wondering if anyone has gotten this paid yet? I do know from my research that when billing for my provider I would use the category cat III code 0715T in conjunction with the primary procedure code, but since there is no Medicare fee schedule for this code yet I am having issues with getting my corporate office to even add this code for billing in our system. I did also see where someone asked what the hospital code for this was and again from my research the hospital code to use is C1761. Thanks for any assistance in billing with this code.
 
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Elkhart, IN
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What HCPCS code is everyone using when a coronary IVL is done? Should C1725 be used instead of C1761? Is anyone else running into device edits when the physcian goes off label with the IVL catheter?
I was wondering if you have found any guidance for this? I am coding for an op surgery center and the physician is doing the transluminal lithotripsy but not placing a stent. We are also getting a lot of these back. Thank yo for your help!
 

ldickerson58

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I was wondering if you have found any guidance for this? I am coding for an op surgery center and the physician is doing the transluminal lithotripsy but not placing a stent. We are also getting a lot of these back. Thank yo for your help!
The shockwave lithotripsy is an add on code to be billed with either an angioplasty, atherectomy and/or stent. If your provider did not do a stent was an angioplasty performed? And you would more than likely need to submit records with the claim. This is a new code that has no Medicare fee schedule attached to it.
 
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