2025 CPT code 92978
(Active) Effective Date: N/A Revision Date: N/A Cardiology - Add-on codes for reporting procedures performed in addition to coronary and bypass graft diagnostic and interventional services Cardiovascular System Feed
Intravascular ultrasound (IVUS) or optical coherence tomography (OCT) imaging of coronary vessel or graft during diagnostic evaluation and/or therapeutic intervention; initial vessel.
Modifiers 26 (professional component) and TC (technical component) may apply depending on who performed the service. Consult guidelines for appropriate modifier usage.
IVUS/OCT imaging is medically necessary when clinically indicated to assess the extent of coronary artery disease before or after interventional procedures, to guide treatment decisions, and optimize procedure success.The necessity must be documented in the patient's chart.This includes situations where there is uncertain anatomy, in-stent restenosis, or other situations where improved visualization is required.
The cardiologist or interventional cardiologist is responsible for performing the IVUS/OCT imaging, interpreting the images, and generating a report that documents the findings.This is usually performed during a cardiac catheterization procedure.
In simple words: This code covers a special heart scan using ultrasound or a similar technology to look at the inside of a heart artery or a graft (a replacement vessel). The scan helps doctors see blockages and plan the best treatment. It's always used with another code for the main heart procedure.
This CPT code, 92978, reports endoluminal imaging of a coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention.The imaging includes supervision, interpretation, and a report. This code is for the initial vessel imaged; additional vessels require the use of code 92979.It's an add-on code and must be used in conjunction with a primary procedure code for coronary intervention.
Example 1: A patient undergoes PCI for a single-vessel lesion in the LAD artery.Prior to stent placement, IVUS imaging (92978) is performed to assess the lesion characteristics and guide stent selection and placement. , A patient presents with unstable angina. Coronary angiography reveals multi-vessel disease.Before intervention, IVUS (92978) is used to evaluate the severity of stenosis in the left main artery, followed by OCT (92979) imaging of the circumflex artery to assess for additional disease. , A patient has undergone previous PCI. Repeat angiography shows in-stent restenosis. Before intervention, IVUS (92978) is performed to assess lesion characteristics and to determine whether additional treatment is needed.
Complete medical record with indication for the procedure, imaging results (including images), interpretation, and report detailing the findings relevant to the clinical decision-making process.Consent forms for the procedure and any associated risks.
** Always refer to the most current CPT codebook and NCCI edits for the most up-to-date information and coding guidelines.This code should only be used when IVUS or OCT is performed. This is an add-on code. It cannot be billed independently.
- Payment Status: Active
- Modifier TC rule: Modifier TC may be appended if only the technical component of the service is performed and billed separately.Otherwise, TC is typically not appended, as this is an add-on code.
- Specialties:Cardiology, Interventional Cardiology
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient and Outpatient), Cardiac Catheterization Laboratory