Summary & Overview

CPT 0366T: Deleted Cardiology Outpatient Hospital Procedure Code

CPT code 0366T was a cardiology-specific billing code used for outpatient hospital procedures, but it was officially deleted effective January 1, 2019. This change impacts providers, payers, and health systems nationwide, as the code is no longer recognized for reimbursement or reporting. The publication highlights the implications of this deletion, including its relevance to major payers such as Blue Cross Blue Shield and Cigna Health. Readers will gain insight into the clinical context of the code, typical sites of service, and how its removal affects billing practices in cardiology. The summary also provides an overview of related codes and modifiers, offering a comprehensive perspective on procedural coding updates and policy changes in cardiovascular care. This article is essential for understanding the evolving landscape of medical billing and coding in cardiology, with a focus on outpatient hospital services and payer coverage.

Blue Cross Blue ShieldCigna Health0366TCardiologyOutpatient HospitalCPT Code DeletionMedical BillingPolicy UpdateClinical CodingCardiovascular DiseaseInterventional CardiologyInternal Medicine

CPT Code Overview

CPT 0366T was previously used in cardiology to describe a specific outpatient hospital procedure. As of January 1, 2019, this code has been deleted and is no longer active for billing or reporting purposes. The typical site of service for procedures billed under CPT 0366T was the outpatient hospital setting, designated as POS 22. This code was relevant for cardiovascular services, reflecting the ongoing evolution of procedural coding in cardiology. Further details about the clinical context and replacement codes are addressed in subsequent sections. Data not available in the input regarding the specific procedure previously described by CPT 0366T.

Clinical & Coding Specifications

Clinical Context

A patient with known or suspected coronary artery disease presents to the outpatient hospital setting for evaluation and management. The clinical workflow typically involves assessment for symptoms such as chest pain, angina, or evidence of myocardial infarction. Diagnostic imaging and interventional procedures may be performed to assess the severity of coronary artery disease and guide treatment. The procedure previously described by CPT code 0366T would have been part of this workflow, but this code was deleted effective January 1, 2019. Patients may have diagnoses such as atherosclerotic heart disease, angina pectoris, or acute myocardial infarction, which are relevant to the cardiology service type and procedures performed in this setting.

Coding Specifications

Modifiers:
- Modifier 26: Used to indicate the professional component of the service, typically when the physician interprets the results but does not own the equipment.
- Modifier TC: Used for the technical component, representing the use of equipment and technical staff without physician interpretation.
- Modifier 59: Used to indicate a distinct procedural service, when procedures are performed separately and are not normally reported together.
Provider Taxonomies:

National Reimbursement Benchmarks

For CPT code 0366T, Blue Cross Blue Shield's national mean rate is $33.57, which is substantially higher than the average commercial mean rate (BUCA) of $13.45 and Cigna's mean rate of $13.42. This highlights a significant difference in reimbursement levels between Blue Cross Blue Shield and other major commercial payers.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, is tightest for Cigna and BUCA, both showing a range of $0.00, indicating highly consistent rates nationally. Blue Cross Blue Shield has a slightly wider range of $0.00 as well, but its mean rate is notably higher than the other payers.

The table and chart below present the full breakdown of national benchmarks for CPT code 0366T across the major commercial payers.

National Mean Rates for CPT Code 0366T by Payer

Related CPT Codes

92928: Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch. This code is used for stent placement and angioplasty, often performed in patients with coronary artery disease.
92920: Percutaneous transluminal coronary angioplasty; single major coronary artery or branch. This code represents angioplasty without stent placement and may be used as an alternative or in conjunction with other procedures.
93458: Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography. This code is used for diagnostic imaging of the coronary arteries and is commonly performed prior to interventional procedures.
92978: Intravascular ultrasound (IVUS) during diagnostic evaluation and/or therapeutic intervention, coronary vessel or graft; initial vessel. This code is used for imaging within the coronary vessels to assess plaque and vessel structure, often used alongside angioplasty or stent placement.

These codes are related to the primary CPT code 0366T in the clinical workflow for diagnosing and treating coronary artery disease. They may be used together or as alternatives depending on the patient's condition and procedural requirements.

`207RC0000X`	Cardiovascular Disease Physician
`207RI0011X`	Interventional Cardiology Physician
`207R00000X`	Internal Medicine Physician

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Summary & Overview

CPT 0366T: Deleted Cardiology Outpatient Hospital Procedure Code

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

Related Codes