Grafts including interventions within a bypass graft or through graft may be difficult for some coders. There several key tips worth knowing to master this area. Let’s take a look at the rationale behind these codes for proper understanding.
Codes for Comprehension
The following codes are associated with these services:
| 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 |
| C9604 | Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel |
| +92938 | 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; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure) |
| +C9605 | Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure) |
Billing Tips Worth Noting
Understand that code 92937 or C9604 describe ANY combination of atherectomy, stenting and angioplasty (if PTCA performed) within a graft or through a graft that connects to a major coronary artery (left main, LAD, LCX, RCA, ramus intermedius) or a branch of the major coronary artery (LAD, LCX, RCA). Even more code 92938 or C9605 describes ANY combination of atherectomy, stenting and angioplasty (if
PTCA performed) within a graft or through a graft each additional branch of a major coronary artery (LAD, LCX, RCA) and represents and add-on code to the primary intervention.
Note that codes 92937 or C9604 and +92938 or +C9605 describe an intervention by any combination of atherectomy, stenting and angioplasty within a bypass graft or through the graft to perform an intervention within the native vessel. What else is included within these codes? Codes 92937 or C9604 and +92938 or +C9605 include the deployment and use of a distal embolic protection device.
How many times can a coder report 92937 and C9604? Code 92937 or C9604 is reported only one time even if more than one of any combination of atherectomy, stenting and angioplasty is performed within a bypass graft or through the graft to perform an intervention within the native vessel.
In addition, code 92937 or C9604 can be reported each time any combination of atherectomy, stenting and angioplasty is performed within a separate bypass graft or through the graft to perform an intervention within a separate native vessel.
Code +92938 or +C9605 is reported for the secondary procedure of any combination of atherectomy, stenting and angioplasty within a branch supplied by the bypass graft (primary procedure performed by 92937 or C9604). Know that code +92938 or +C9605 can be reported a maximum of two times. Understand that code +92938 or +C9605 is an add-on code and can be additionally reported only in addition to the primary combination code 92937 or C9604.
Explore more coding knowledge and additional pressing topics to master compliance and coding with our Peripheral & Cardiology Coder. Take control of the chronically challenging issues and changes that may put your facility at risk for claim denials, underpayment, and auditor action
