2025 CPT code 92998
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular Procedure - Angioplasty Cardiovascular Feed
Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel.
Modifiers 51 (multiple procedures), 58 (staged or related procedure), 59 (distinct procedural service), and others may be applicable depending on the circumstances.Appropriate modifier selection is critical for proper reimbursement.
Medical necessity is established through pre-procedure diagnostic imaging showing significant pulmonary artery stenosis compromising blood flow to the lungs.The procedure is indicated when conservative management has failed, and the stenosis significantly affects the patient's quality of life and/or lung function.
The physician is responsible for the entire procedure, including catheter insertion, balloon inflation, angiographic imaging (if performed), and post-procedure care.
In simple words: This code describes a procedure where a doctor uses a tiny balloon on a thin tube to open up a blocked blood vessel in the lung. This code is only used if more than one blood vessel needs treatment.It's an additional charge, added on to the charge for the first blood vessel treated.
This CPT code, 92998, reports percutaneous transluminal pulmonary artery balloon angioplasty for each additional pulmonary artery vessel treated.This is an add-on code and must be reported in addition to the primary procedure code (92997) for the initial pulmonary artery angioplasty. The procedure involves inserting a balloon-tipped catheter into a pulmonary artery, inflating the balloon to widen the artery and improve blood flow, and then removing the catheter.Imaging (angiography) is typically used to guide catheter placement and assess treatment effectiveness.
Example 1: A patient presents with pulmonary artery stenosis affecting two major branches.The physician performs a balloon angioplasty on the first branch using 92997, and then uses 92998 to bill for the second branch treatment., A patient with severe pulmonary hypertension and multiple stenotic pulmonary arteries requires staged angioplasty. The initial procedure addresses one major artery (92997), followed by subsequent procedures on additional branches (92998) at later sessions.This strategy minimizes patient risk., During a planned pulmonary angioplasty for a single artery (92997), unexpected stenosis in another artery is discovered.The physician proceeds to treat the second artery during the same procedure, and this additional treatment is coded using 92998.
* Pre-procedure diagnostic imaging (e.g., CT scan, echocardiogram) demonstrating the need for the procedure.* Angiographic images obtained before, during, and after the procedure.* Documentation of the number of vessels treated.* Operative report detailing the procedure performed on each vessel.* Post-procedure assessment and follow-up care.
** Accurate reporting requires precise documentation of the number of vessels treated and the relationship to the primary procedure (92997).Any discrepancies in documentation can lead to claim denials.
- Revenue Code: P2F (Major Procedure, Cardiovascular - Other)
- RVU: This information is not provided and requires consultation with the payer's fee schedule.
- Global Days: The global period is not specified for this add-on code and depends on the global period defined for the primary procedure (92997).
- Payment Status: Active
- Modifier TC rule: No TC modifier is applicable to this add-on code.
- Fee Schedule: This information is not provided and varies by payer and location.Consult the payer's fee schedule for historical and current rates.
- Specialties:Cardiology, Interventional Cardiology, Cardiovascular Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center