2025 CPT code 92920
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Procedures - Percutaneous Coronary Intervention (PCI) Cardiology Feed
Percutaneous transluminal coronary angioplasty of a single major coronary artery or branch.
Modifiers may apply depending on the circumstances of the procedure.For example, modifier 59 (distinct procedural service) might be used if the procedure is performed on separate vessels during the same session.Modifiers 22 (increased procedural services) and 51 (multiple procedures) might be considered if appropriate.
Medical necessity for PTCA is established by the presence of significant coronary artery stenosis causing symptoms such as angina, shortness of breath, or myocardial infarction. The procedure is typically recommended when medical management fails to control symptoms or when there is evidence of significant myocardial ischemia.
The interventional cardiologist is primarily responsible.This includes pre-procedure evaluation, obtaining informed consent, performing the procedure, post-procedure monitoring, and follow-up care.
In simple words: This procedure uses a small balloon on a thin tube (catheter) inserted into a blocked heart artery to widen it and improve blood flow.A dye and X-ray are used to guide the catheter. The balloon is inflated to push the blockage against the artery wall, restoring blood flow.
This CPT code 92920 represents percutaneous transluminal coronary angioplasty (PTCA) performed on a single major coronary artery or one of its branches.The procedure involves accessing the artery (usually via the femoral or brachial artery), catheterizing the vessel, traversing the lesion, utilizing radiological guidance, performing angioplasty (balloon dilation), and documenting the completion of the intervention.It includes the work of accessing and selectively catheterizing the vessel, traversing the lesion, radiological supervision and interpretation directly related to the intervention(s) performed, closure of the arteriotomy when performed through the access sheath, and imaging performed to document completion of the intervention.Balloon angioplasty is always included. Atherectomy or stenting may be performed in addition to balloon angioplasty but are included in the code.
Example 1: A 65-year-old male presents with stable angina. Coronary angiography reveals a significant stenosis in the proximal left anterior descending artery.PTCA with balloon angioplasty is performed to restore blood flow., A 72-year-old female experiences an acute myocardial infarction.Coronary angiography shows a totally occluded right coronary artery.Emergency PTCA with stent placement is performed., A 58-year-old male with a history of coronary artery disease presents with worsening angina. Angiography demonstrates a significant stenosis in the mid-left circumflex artery and a minor stenosis in a branch of the circumflex.PTCA is performed on the mid-circumflex; the minor stenosis is managed medically.
* Comprehensive history and physical examination.* Pre-procedure coronary angiography (if not performed as part of this procedure and if clinically necessary).* Intra-procedure fluoroscopy images documenting lesion location and treatment.* Post-procedure angiography demonstrating improved blood flow.* Discharge instructions and follow-up plan.
** Always refer to the most current CPT manual and payer-specific guidelines for accurate coding.This information is for educational purposes only and should not be considered definitive medical advice.
- Revenue Code: 0450, 0452 (Examples - specific revenue codes depend on payer and facility)
- RVU: RVUs vary significantly based on geographic location, facility type (inpatient vs. outpatient), and other factors. Consult your local fee schedule or Medicare Physician Fee Schedule for current values.
- Global Days : The global period for this procedure is usually 0 days, meaning that post-procedure care is reported separately.However, this can vary depending on payer guidelines.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is generally not applicable to this code as it's a comprehensive procedural code.
- Fee Schedule : Historical fee schedules are not included here, but they are available via payer-specific websites, and vary based on year and location. Medicare's Physician Fee Schedule is a good publicly available example.
- Specialties:Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center