2025 CPT code 92943
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Procedure - Percutaneous Transluminal Coronary Angioplasty Medicine Services and Procedures > Cardiovascular Procedures > Therapeutic Cardiovascular Services and Procedures Feed
Percutaneous transluminal coronary angioplasty with stent placement for chronic total occlusion of a single coronary artery, branch, or bypass graft.
Modifiers may be necessary depending on the circumstances.For example, modifier 59 might be used to indicate a distinct procedural service from other services provided on the same day.Consult the most up-to-date modifier guidelines.
Medical necessity for this procedure is established by the presence of significant ischemic symptoms (such as angina or shortness of breath) despite optimal medical management and confirmation of chronic total occlusion via angiography.Documentation must justify the need for PCI rather than other treatment options.
The clinical responsibility for this procedure rests primarily with a cardiologist or interventional cardiologist.This physician will perform the procedure, interpret angiograms, and manage the patient’s care.
- Medicine Services and Procedures > Cardiovascular Procedures > Therapeutic Cardiovascular Services and Procedures
- This code is part of a family of CPT codes (92920-92944) describing percutaneous coronary interventions (PCI).The hierarchy is based on service intensity, with 92943 representing a high level of service intensity. Add-on codes (e.g., 92944) exist for additional interventions within the same session.
In simple words: This code represents a procedure to open a completely blocked artery in the heart.A thin tube is inserted into a blood vessel in the arm or leg and guided to the blocked artery.Special tools are used to clear the blockage and a small mesh tube (stent) is placed to keep the artery open.
This CPT code 92943 describes percutaneous transluminal revascularization of a chronically totally occluded coronary artery, branch, or bypass graft.The procedure involves techniques such as intracoronary stent placement, atherectomy, and angioplasty, possibly in combination, to restore blood flow through a single vessel.This is performed for chronic total occlusion, meaning there is no antegrade flow through the true lumen, indicated by angiographic and clinical criteria.It excludes acute myocardial infarction cases with ST elevation or Q wave.Balloon angioplasty is always included.Diagnostic coronary angiography may be reported separately under specific circumstances. The code includes the work of accessing and selectively catheterizing the vessel, traversing the lesion, radiological supervision and interpretation, closure of the arteriotomy (if applicable), and imaging to document completion.
Example 1: A 65-year-old male presents with angina and a history of previous myocardial infarction. Coronary angiography reveals a chronic total occlusion in the left anterior descending artery.PCI with stent placement is performed using code 92943., A 72-year-old female with a history of coronary artery bypass graft surgery experiences recurrent chest pain.Angiography shows a chronic total occlusion in one of the bypass grafts.PCI using 92943 is performed to restore blood flow., A 58-year-old male presents with unstable angina. Coronary angiography reveals chronic total occlusion in a branch of the right coronary artery.The physician performs PCI with stent placement (92943) to revascularize the affected branch.
Complete medical history, physical examination findings, indication for the procedure (including angiographic images demonstrating chronic total occlusion), details of the procedure (including access site, vessels treated, type and number of stents placed, and any complications), and post-procedure angiographic images.
** This code is highly dependent on accurate documentation to ensure proper reimbursement.Any ambiguity in documentation can lead to claim denials.Consider using a qualified coding specialist to validate the coding selection.
- Revenue Code: The specific revenue code will depend on the payer and the place of service.
- RVU: RVUs vary by geographic location and payer. Consult your local Medicare fee schedule or the payer's specific fee schedule for the most current RVU values.
- Global Days: The global period for this procedure will vary depending on payer and local guidelines.This may need to be clarified with the payer.
- Payment Status: Active
- Modifier TC rule: The technical component (TC) modifier applies depending on the payer and place of service. Refer to the specific billing guidelines of the payer.
- Fee Schedule: Historical fee schedules will vary depending on the payer and geographic location. Data on past fee schedules are not available in this response.
- Specialties:Cardiology, Interventional Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center