2025 CPT code 92938
(Active) Effective Date: N/A Medicine - Cardiovascular Procedures Feed
Percutaneous transluminal revascularization of a coronary artery bypass graft, including stent placement, atherectomy, and angioplasty with distal protection, when performed, on each additional branch linked through bypass graft.
Modifiers may be applicable. Modifier 52 may be used for reduced services. Modifier 78 may be used for unplanned return to the operating room.
Medical necessity for 92938 is established by documenting the presence of significant stenosis or blockage in a branch of a coronary artery bypass graft, causing symptoms or jeopardizing cardiac function. The documentation should support the need for intervention to restore blood flow.
At the same session as a percutaneous transluminal revascularization for a single vessel performed in or through a coronary artery bypass graft, the provider gains access to additional branch linked through a coronary artery bypass graft.The provider makes an incision into the brachial or femoral artery and inserts a guide wire. A guide catheter is inserted over the guide wire and advanced to the coronary artery bypass graft. Fluoroscopic images are taken to guide catheter placement. A distal protection device is placed. A catheter with a blade is advanced to remove blockage. A balloon-tipped catheter is inserted and inflated to flatten plaque. A stent is placed using a balloon-mounted catheter. Angioplasty may also be performed.Equipment is removed, hemostasis achieved, and the wound closed.
- Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed.
In simple words: This procedure involves opening up a blocked blood vessel in a bypass graft around the heart. It may include placing a stent, removing plaque, and widening the vessel. This code is used for each additional branch connected to the bypass graft treated during the same procedure.
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure)
Example 1: A patient with a previous coronary artery bypass graft presents with angina. Angiography reveals a blockage in a branch off the graft. During the procedure, the cardiologist performs a percutaneous transluminal revascularization of the blocked branch, including stent placement., A patient has a blockage in two branches subtended by a coronary artery bypass graft. The physician performs a percutaneous revascularization procedure on both branches during the same session, using a combination of atherectomy and stent placement., A patient with prior CABG presents for treatment. During the procedure to address a blockage in the main graft vessel, another blockage is discovered in a branch stemming from the graft. The interventional cardiologist performs an angioplasty on this additional branch.
Documentation should include details of the procedure, such as the type of bypass graft, the location of the blockage(s), the interventions performed (stent, atherectomy, angioplasty), use of distal protection, and any complications. Pre- and post-procedure angiography findings should be documented. Medical necessity for the procedure should also be established.
- Revenue Code: P2F - MAJOR PROCEDURE, CARDIOVASCULAR - OTHER
- Payment Status: Active
- Specialties:Cardiology, Interventional Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center