Summary & Overview
CPT 0914T: Percutaneous Coronary Drug Delivery with Drug-Coated Balloon
CPT code 0914T is an add-on coronary intervention code that captures percutaneous delivery of therapeutic drugs via a drug-coated balloon, combined with mechanical dilation using a nondrug-coated balloon and intraprocedural imaging. As an adjunct to a primary coronary revascularization service, this procedure reflects evolving device-based pharmacotherapy strategies intended to reduce restenosis and improve vessel patency.
Nationally, the code matters because it represents a specialized, device-dependent service typically performed in hospital catheterization laboratories or ambulatory surgical centers and billed alongside primary revascularization CPT codes. Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find clinical and billing context for CPT code 0914T, including how the service is defined, typical sites of service, and the role of imaging in the procedure. The publication outlines typical payer coverage considerations, common modifier usage when available, and operational benchmarks where provided. It also summarizes policy and coding implications that affect billing practices for add-on coronary drug-delivery procedures and highlights issues organizations should consider when reconciling device-based interventions with primary revascularization claims. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 0914T describes an add-on percutaneous coronary drug-delivery procedure performed in conjunction with a primary coronary revascularization service. The provider delivers therapeutic medication by catheter to a major coronary artery or a branch using a drug-coated balloon; the service also includes mechanical dilation with a non–drug-coated balloon and the use of imaging techniques to guide and confirm the intervention.
Service type: Percutaneous coronary drug-delivery with adjunct balloon angioplasty and intraprocedural imaging
Typical site of service: Hospital-based catheterization laboratory or ambulatory surgical center (cardiac catheterization lab)
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with symptomatic coronary artery disease presenting with exertional angina and angiographic evidence of a focal, flow-limiting atherosclerotic lesion in a major coronary artery or branch. The interventional cardiology team evaluates the patient for percutaneous coronary intervention (PCI). During the index coronary revascularization procedure, after guidewire crossing and diagnostic coronary angiography, the operator performs mechanical lesion preparation and dilation with a nondrug-coated balloon, obtains intravascular imaging (intravascular ultrasound or optical coherence tomography) to guide sizing and confirm stent apposition, and then delivers a drug-coated balloon via a percutaneous catheter to the target segment to apply antirestenotic medication. The procedure is performed in a cardiac catheterization laboratory under moderate sedation or monitored anesthesia care. Typical workflow steps include vascular access (radial or femoral), diagnostic angiography, lesion crossing, predilation with a nondrug-coated balloon, intravascular imaging for lesion assessment and sizing, delivery of the drug-coated balloon, post-dilation as needed, hemostasis, and post-procedure monitoring in a recovery area or coronary care unit depending on patient risk.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier used/standard reporting | Applied when no special modifier applies to the service billing; some systems use 00 as default. |
22 | Increased procedural services | Use when the service required substantially greater work or complexity than typical for the primary revascularization service. |
51 | Multiple procedures | Use when multiple procedures are performed in the same session and payer requires reporting of additional procedures. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as intended. |
53 | Discontinued procedure | Use when the procedure is terminated due to patient-related or unforeseen circumstances. |
62 | Two surgeons | Use when two surgeons work together as primary operators when required for the procedure. |
66 | Surgical team | Use when a surgical team performs components of the procedure requiring team reporting. |
78 | Unplanned return to OR/invasive procedure | Use when an unplanned return for a related interventional procedure occurs during the postoperative period. |
80 | Assistant at surgery | Use when an assistant surgeon actively assists during the procedure. |
82 | Assistant surgeon (when qualified resident not available) | Use when an assistant surgeon is needed and a qualified resident is unavailable. |
73 | Discontinued outpatient hospital/ambulatory surgery prior to anesthesia | Use when the outpatient procedure is cancelled after patient preparation but before anesthesia. |
53 | Procedure discontinued (duplicate shown intentionally per common CMS set) | Use when discontinuation occurs after initiation; (note: 52 and 53 are distinct: 52 reduced, 53 discontinued). |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist billing (state-specific) | Use when an advanced practice clinician performs or assists in portions of the service per payer rules. |
XE | Separate encounter, distinct procedural service | Use when a service is distinct because it occurred during a separate encounter on a different date. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Cardiology | Interventional cardiologists perform coronary revascularization and use percutaneous drug-coated balloon therapies. |
| 2084P0800X | Interventional Cardiology | Subspecialty taxonomy for physicians focused on percutaneous coronary interventions. |
| 208800000X | Cardiovascular Disease | General cardiologists who may be involved in diagnostic angiography and pre/post procedure care. |
| 364S00000X | Vascular Surgery | Vascular surgeons may participate in access management or complex peripheral-coronary hybrid procedures. |
| 367500000X | Registered Nurse First Assistant (RNFA) | Peri-procedural support in the catheterization laboratory and assistance with hemostasis. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I25.10 | Atherosclerotic heart disease of native coronary artery without angina pectoris | Common indication for percutaneous coronary interventions, including drug-coated balloon adjuncts in focal lesions. |
I20.9 | Angina pectoris, unspecified | Symptomatic ischemia prompting diagnostic angiography and possible percutaneous therapy. |
I25.110 | Atherosclerotic heart disease of native coronary artery with unstable angina | Acute or unstable presentations where revascularization techniques are applied. |
I21.3 | ST elevation (STEMI) myocardial infarction of unspecified site | Acute MI scenarios where adjunctive therapies may be considered during urgent PCI. |
I70.209 | Atherosclerosis of artery of extremities, unspecified, unspecified extremity | Included when peripheral atherosclerotic disease coexists and hybrid vascular interventions occur (less directly related but may be present in complex patients). |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
93458 | Catheter placement; coronary angiography including intraprocedural injections for coronary angiography when performed; with left heart catheterization including intraprocedural injections for left ventriculography, when performed, and invasive coronary intervention | Often performed before or as part of the same session to define anatomy and guide the drug-coated balloon intervention. |
92928 | Percutaneous transluminal coronary atherectomy, and/or percutaneous transluminal coronary angioplasty; with stent placement, single major coronary artery or branch | May be performed in the same episode when stenting is required in addition to or instead of drug-coated balloon therapy. |
92920 | Percutaneous transluminal coronary angioplasty; single major coronary artery or branch | Represents balloon angioplasty; nondrug-coated balloon dilation described in the add-on code is part of this mechanical dilation step. |
93571 | Intravascular ultrasound (IVUS) including interpretation and report, when performed; coronary | IVUS is an imaging technique used to guide and confirm sizing and apposition during the procedure. |
92973 | Percutaneous transluminal coronary thrombectomy, any method | May be performed prior to drug-coated balloon delivery if thrombus burden requires removal to optimize drug delivery. |
99152 | Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service, initial 15 minutes | Represents sedation/monitoring services commonly used during the catheterization procedure. |