CPT 93582 Transcatheter PDA Closure Reimbursement | OpenPayer

Summary & Overview

CPT 93582: Transcatheter Closure of Patent Ductus Arteriosus

CPT code 93582 denotes the percutaneous transcatheter closure of a patent ductus arteriosus (PDA), a congenital connection between the pulmonary artery and aorta. This minimally invasive interventional cardiology procedure provides an alternative to open surgical ligation and is significant for reducing recovery time and resource utilization for pediatric and adult congenital heart patients. Nationally, transcatheter PDA closure is an established treatment within congenital heart disease programs and cardiac catheterization laboratories.

Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication covers payer coverage considerations and typical site-of-care configurations for this service across major commercial and public payers.

Readers will find an overview of clinical context for PDA closure, typical sites of service and care settings, common billing modifiers relevant to procedure reporting, and guidance on coding nomenclature. Where available, benchmarking information and policy updates affecting authorization and coverage processes are summarized. Data gaps in the input are noted as unavailable; the content focuses on the procedural description, payer landscape, and operational implications for facilities and billing teams.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare93582CPTtranscatheterpatent-ductus-arteriosusinterventional-cardiologycardiac-catheterizationpediatric-cardiology

Billing Code Overview

CPT code 93582 describes a percutaneous, catheter-based closure of a patent ductus arteriosus (PDA), a congenital vascular connection between the pulmonary artery and the aorta. The procedure is performed by inserting a catheter through the skin and advancing it through the vascular system to deploy a closure device at the PDA, achieving occlusion without an open surgical approach.

Service type: Interventional cardiology procedure — transcatheter PDA closure

Typical site of service: Cardiac catheterization laboratory or interventional radiology suite

Clinical & Coding Specifications

Clinical Context

A typical patient is an infant or young child diagnosed with a hemodynamically significant patent ductus arteriosus (PDA) presenting with signs of congestive heart failure, poor weight gain, tachypnea, or a continuous murmur on exam. The cardiology team schedules a transcatheter device closure under general anesthesia in a pediatric cardiac catheterization laboratory. Vascular access is obtained percutaneously (commonly femoral vein and/or artery), and fluoroscopic and echocardiographic guidance (often transesophageal or transthoracic) is used to cross the ductus, size the defect with angiography, and deploy an occlusion device. Hemodynamic measurements, oxygen saturations, and angiographic runs are performed before device selection. Post-deployment angiography and echocardiography confirm device position and absence of residual shunt or obstruction to adjacent structures. The patient is monitored in a post-anesthesia care unit or pediatric cardiac observation unit for complications such as vascular injury, device embolization, arrhythmia, or hemolysis before discharge or admission for observation. The procedural workflow typically involves the interventional pediatric cardiologist, pediatric cardiac anesthesiologist, catheterization lab nursing and technologist staff, and echocardiography support for intra-procedural imaging.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s professional interpretation or supervision portion of a service if separated from technical component.

CPT 93580: Transcatheter Atrial Septal Defect Closure

CPT-93581-TRANSCATHETER-VENTRICULAR-SEPTAL-DEFECT-CLOSURE

CPT 93581: Transcatheter Ventricular Septal Defect Closure

Taxonomy Code	Specialty	Notes
2080P0206X	Pediatric Cardiology	Interventional pediatric cardiologists commonly perform `93582`.
207RC0000X	Interventional Cardiology	Adult interventional cardiologists with congenital training may perform transcatheter PDA closures in older patients.
207K00000X	Cardiovascular Disease	General cardiologists involved in pre- and post-procedure management.
2084P0800X	Pediatric Critical Care Medicine	Provides peri-procedural critical care for complex infants.
363L00000X	Pediatric Anesthesiology	Pediatric anesthesiologists provide general anesthesia for the procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q25.0`	Patent ductus arteriosus	Primary diagnosis for which `93582` is performed; confirms congenital communication between pulmonary artery and aorta.
`P28.5`	Patent ductus arteriosus, newborn	Neonatal designation of PDA commonly requiring transcatheter closure in appropriate patients.
`I50.9`	Heart failure, unspecified	Used when PDA has produced symptomatic congestive heart failure prompting closure in older infants or children.
`R62.51`	Failure to thrive (child)	Relevant when chronic volume overload from PDA results in poor weight gain.
`I35.0`	Nonrheumatic aortic (valve) stenosis	Listed because evaluation may identify associated pathologies needing attention — included only if documented.
`Z98.890`	Other specified postprocedural states	May be used in follow-up documentation after device placement when applicable.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93452`	Left heart catheterization, coronary angiography when performed; with ventriculography, when performed	May be performed in evaluation of associated structural lesions or for hemodynamic assessment when additional catheterization is required.
`93458`	Right heart catheterization including measurement(s) of cardiac output, when performed	Often performed before device closure to obtain pulmonary and systemic pressures and shunt calculations.
`93312`	Transesophageal echocardiography, intraoperative or periprocedural	Intra-procedural TEE used to guide device positioning and assess residual shunt.
`93799`	Unlisted cardiovascular service or procedure	Used when a specific ancillary transcatheter technique or novel device deployment is not represented by existing codes.
`36415`	Collection of venous blood by venipuncture	Common ancillary service for pre- and post-procedure laboratory testing.
`51701`	Catheterization of bladder if urinary catheterization is required for monitoring	Occasionally used for catheter management in small infants (use as clinically documented).

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