Summary & Overview
CPT 92928: Percutaneous Coronary Stent Placement with Angioplasty
CPT code 92928 is a critical billing code in cardiovascular care, representing the percutaneous transcatheter placement of intracoronary stents with angioplasty for a single major coronary artery or branch. This procedure is widely performed to address coronary artery disease, a leading cause of morbidity and mortality in the United States. The code is relevant for hospital outpatient departments and ambulatory surgical centers, reflecting its use in acute and elective settings.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, provide coverage for this procedure, underscoring its clinical and financial significance. The publication offers insights into payer coverage, policy updates, and clinical benchmarks for 92928, helping readers understand the landscape of reimbursement and utilization. It also contextualizes the procedure within interventional cardiology, highlighting its role in treating conditions such as atherosclerotic heart disease and acute myocardial infarction.
Readers will gain a comprehensive overview of the code’s clinical indications, associated diagnoses, and related billing codes, as well as updates on modifiers and taxonomy classifications. The summary provides a clear framework for understanding how 92928 fits into broader cardiovascular service lines and payer policies, supporting informed decision-making for stakeholders across the healthcare spectrum.
CPT Code Overview
CPT code 92928 describes the percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed, for a single major coronary artery or branch. This procedure is a cornerstone of interventional cardiology, used to treat patients with coronary artery disease by restoring blood flow through blocked or narrowed arteries. The typical site of service for this procedure includes hospital outpatient settings or ambulatory surgical centers (ASC), such as outpatient hospital (POS 19) or ASC (POS 24).
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the hospital outpatient department or ambulatory surgical center with symptoms suggestive of coronary artery disease, such as chest pain or evidence of myocardial ischemia. Diagnostic evaluation confirms significant stenosis in a single major coronary artery or branch. The interventional cardiologist performs a percutaneous transcatheter placement of an intracoronary stent, often accompanied by coronary angioplasty, to restore blood flow. The procedure is indicated for conditions such as acute myocardial infarction, unstable angina, or chronic atherosclerotic heart disease. Post-procedure, the patient is monitored for complications and managed according to standard cardiovascular protocols.
Coding Specifications
- Modifier
63: Used when the procedure is performed on infants weighing less than 4 kg. This modifier indicates the increased complexity and risk associated with performing the procedure on very small patients.
| Modifier Code | Description |
|---|---|
63 | Procedure performed on infants less than 4 kg |
- Provider Taxonomies: