2025 CPT code 92937
(Active) Effective Date: N/A Revision Date: N/A Cardiology Procedures - Percutaneous Transluminal Coronary Interventions Cardiovascular System Feed
Percutaneous transluminal revascularization of a single coronary artery bypass graft using stent, atherectomy, and angioplasty, with distal protection if performed.
Modifiers may apply in various situations, including multiple procedures (modifier 51), reduced services (modifier 52), and separately identifiable procedures (modifier 59). Consult the latest CPT and payer specific guidelines.
The procedure is medically necessary when a patient demonstrates significant symptoms (e.g., angina, myocardial ischemia) due to hemodynamically significant stenosis within a coronary artery bypass graft, and conservative management has failed to provide adequate relief.Documentation should support the need for intervention and the selection of the specific procedure performed.
The cardiologist or interventional cardiologist is responsible for performing the procedure, including pre-procedural assessment, patient preparation, catheterization, angioplasty, stenting, atherectomy (if performed), and post-procedural care.Anesthesiology services might also be included, dependent on the patient's clinical status and facility protocols.
In simple words: This procedure uses a catheter to open a blocked coronary artery bypass graft (a graft used to reroute blood around a blocked artery in the heart). It may involve placing a stent, removing plaque (atherectomy), or widening the artery (angioplasty).If a protective device is used to prevent blood clots, it's included in this code and doesn't need extra billing.
This CPT code 92937 encompasses percutaneous transluminal revascularization (PTR) performed on a single coronary artery bypass graft (CABG).The procedure may involve any combination of intracoronary stent placement, atherectomy, and angioplasty. Distal protection is included when performed; however, it is not separately billable.The procedure is done through the bypass graft, not the native artery. A sequential bypass graft with one distal anastomosis is considered a single vessel.A branching graft (e.g., Y graft) is considered one vessel, while each branch is an additional vessel and requires separate coding.
Example 1: A patient presents with symptoms of angina due to stenosis in a previously placed saphenous vein graft.92937 is used to describe the percutaneous intervention to restore blood flow using stenting and angioplasty., A patient with an internal mammary artery (IMA) graft experiencing recurrent ischemia undergoes PCI.The procedure involves atherectomy followed by stent placement. 92937 is billed for this single vessel intervention., A patient has a Y-graft bypass, and stenosis is observed in the main graft and one branch. 92937 is coded for the main graft, and 92938 is added for the branch requiring separate intervention.
Complete medical history, including prior cardiac procedures; pre-procedure and post-procedure angiograms with detailed assessment of lesion characteristics, stent placement, and patency; procedural report detailing techniques used, type of stent (if applicable), and any complications encountered; and appropriate imaging documentation to support the medical necessity of the procedure.
** Always verify payer-specific coding guidelines and reimbursement policies before submitting claims.Understanding the nuances of coronary anatomy and PCI procedures is crucial for accurate coding.
- Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
- RVU: RVUs vary based on geographic location and facility type.Consult the appropriate fee schedule for specific values.
- Global Days: Global period details are not specified in the provided data; refer to payer guidelines for specifics.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier may be applicable depending on the billing arrangements and payer guidelines. Consult payer and CPT guidelines for current rules.
- Fee Schedule: Historical fee schedule data is not available in this dataset, but can be obtained from the AMA and CMS.
- Specialties:Cardiology, Interventional Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center