Summary & Overview
CPT 92933: Percutaneous Coronary Atherectomy with Stent and Angioplasty
CPT code 92933 is a pivotal billing code for advanced coronary interventions, specifically percutaneous transluminal coronary atherectomy with stent placement and angioplasty in a single major coronary artery or branch. This procedure is essential in the management of complex coronary artery disease, offering patients improved outcomes through minimally invasive techniques. The code is most commonly utilized in inpatient hospital settings, reflecting the complexity and acuity of cases requiring such intervention.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, provide coverage for this procedure, underscoring its clinical importance and widespread adoption. The publication offers a comprehensive overview of the clinical context, typical sites of service, and payer coverage landscape. Readers will gain insights into relevant benchmarks, policy updates, and the procedural nuances associated with 92933, as well as its relationship to other coronary intervention codes. The summary also highlights the importance of accurate coding and documentation for optimal reimbursement and compliance.
This article serves as a resource for healthcare professionals, administrators, and policy analysts seeking to understand the national landscape for coronary atherectomy procedures, including payer coverage, clinical indications, and coding practices.
CPT Code Overview
CPT code 92933 describes a percutaneous transluminal coronary atherectomy procedure, which includes placement of an intracoronary stent and coronary angioplasty when performed. This code is used for interventions on a single major coronary artery or branch. The service falls under Coronary Therapeutic Services and Procedures and is typically performed in an inpatient hospital setting (Place of Service 21). This procedure is a critical intervention for patients with significant coronary artery disease, aiming to restore blood flow and reduce cardiac risk.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to an inpatient hospital setting with symptoms suggestive of acute coronary syndrome, such as chest pain or unstable angina. Diagnostic evaluation reveals significant atherosclerotic disease in a major coronary artery or branch. The interventional cardiologist determines that percutaneous transluminal coronary atherectomy, with intracoronary stent placement and coronary angioplasty, is indicated to restore blood flow. The procedure is performed in the cardiac catheterization lab, often for patients with complex coronary lesions, including those with unstable angina or acute myocardial infarction.
Coding Specifications
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Modifiers:
26- Professional Component: Used when only the physician's professional services are billed, not the facility or equipment.TC- Technical Component: Used when only the technical portion (facility/equipment) is billed.59- Distinct Procedural Service: Used to indicate that the procedure is distinct or independent from other services performed on the same day.51- Multiple Procedures: Used when multiple procedures are performed during the same session.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
207RC0000X | Cardiovascular Disease Physician |
207RI0011X | Interventional Cardiology Physician |
207RG0300X | Geriatric Medicine Physician |
These taxonomies represent providers specializing in cardiovascular disease, interventional cardiology, and geriatric medicine, who are qualified to perform or manage this procedure.
Related Diagnoses
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I25.10- Atherosclerotic heart disease of native coronary artery without angina pectoris- Indicates chronic coronary artery disease without symptoms; relevant for patients undergoing elective intervention.
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I25.110- Atherosclerotic heart disease of native coronary artery with unstable angina pectoris- Represents patients with significant coronary disease and unstable angina, often requiring urgent intervention.
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I25.119- Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris- Used when angina is present but not further specified; applicable for patients with symptomatic coronary disease.
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I20.0- Unstable angina- Indicates acute coronary syndrome with unstable angina; commonly seen in patients needing immediate revascularization.
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I21.9- Acute myocardial infarction, unspecified- Represents patients with acute heart attack; urgent intervention with atherectomy, stent, and angioplasty may be required.
Related CPT Codes
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92928- Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch- Used for stent placement and angioplasty without atherectomy. May be performed as an alternative or in conjunction with
92933when atherectomy is not required.
- Used for stent placement and angioplasty without atherectomy. May be performed as an alternative or in conjunction with
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92934- Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)- Used as an add-on code when atherectomy, stent, and angioplasty are performed on additional branches beyond the primary vessel treated with
92933.
- Used as an add-on code when atherectomy, stent, and angioplasty are performed on additional branches beyond the primary vessel treated with
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92937- 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; single vessel- Used for similar procedures performed on coronary artery bypass grafts rather than native coronary arteries. May be used as an alternative in patients with prior bypass surgery.