Summary & Overview
CPT 93592: Additional Occlusion Device for Percutaneous Valve Leak
CPT code 93592 denotes the insertion of each additional occlusion device to close a leak around a mitral or aortic prosthetic valve via percutaneous catheter access. This code is used when more than one occlusion device is required to seal a residual paravalvular leak after transcatheter valve implantation or during post-implant interventions. Nationally, the code is relevant as transcatheter valve therapies expand and management of paravalvular leaks becomes more common in interventional cardiology practice.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context, typical sites of service, and the service type represented by the code. The publication summarizes common billing considerations, prevalent modifier usage (provided separately), and how 93592 relates to procedural workflows in catheterization laboratories and ambulatory surgical centers.
This analysis provides clinicians, billing staff, and policy stakeholders with benchmarks and policy-relevant context for claims handling and coding alignment. It highlights where 93592 fits within transcatheter valve care pathways and what operational settings commonly bill this code, aiding consistent documentation and payer communications at a national level.
Billing Code Overview
CPT code 93592 describes insertion of an additional occlusion device to close a leak around the mitral or aortic valve. The procedure is performed percutaneously via catheter access through a small incision in the skin, commonly through the femoral artery or a transcutaneous approach over the heart, and is used when a prosthetic (artificial) valve or other device requires one or more adjunctive occlusion devices to seal a residual paravalvular leak.
Service type: Percutaneous transcatheter occlusion device insertion (additional device)
Typical site of service: Cardiac catheterization laboratory or interventional cardiology suite, often billed for procedures performed in an outpatient ambulatory surgical center or inpatient hospital setting depending on clinical context.
Clinical & Coding Specifications
Clinical Context
A 78-year-old patient with a history of surgical aortic valve replacement presents with progressive dyspnea, new-onset heart failure symptoms, and evidence of hemolytic anemia. Transesophageal echocardiography demonstrates a paravalvular leak around the prosthetic aortic valve with moderate-to-severe regurgitation and a jet localized to the sewing ring. The interventional structural heart team elects to perform a percutaneous, catheter-based valve leak occlusion procedure. Under general anesthesia in the cardiac catheterization laboratory or hybrid operating room, vascular access is obtained (typically femoral arterial and/or venous). Using fluoroscopic and echocardiographic guidance, the operator crosses the paravalvular defect and deploys an occlusion device; additional devices are often required to fully seal irregular or multiple defects. Hemodynamic and imaging confirmation of reduced regurgitation is obtained prior to sheath removal and closure. Typical monitoring includes continuous arterial pressure, transesophageal echocardiography, and postprocedural observation in a cardiac step-down or intensive care unit. This procedure is performed percutaneously and billed per additional occlusion device using 93592 for each device beyond the first.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Use when two surgeons work together as primary surgeons during the procedure (rare for percutaneous PVL closure). |