In 2025, Category III codes 0913T and 0914T were introduced to streamline the reporting of percutaneous coronary interventions (PCI) by combining drug-coated balloon (DCB) angioplasty with advanced imaging techniques like intravascular ultrasound (IVUS) or optical coherence tomography (OCT). DCB angioplasty is a minimally invasive technique delivering antiproliferative drugs directly to narrowed or blocked arteries, promoting long-term vessel patency without permanent implants. These new codes reflect the growing role of innovative, precise therapies in coronary artery disease (CAD) management, ensuring accurate documentation and facilitating optimal reimbursement. Understanding key nuances is critical for correct and compliant coding come 2025. Let’s examine the details to score success now and throughout the new year.
Critical Understanding of Coronary Intervention via Drug Delivery Balloon
First, we need to understand what makes each code selection unique. Let’s start with Code 0913T. Code 0931T details PCI utilizing drug-eluting or drug-coated angioplasty and includes mechanical dilation with a non-drug delivery balloon and IVUS or OCT, when performed, on a major coronary artery or graft (left main, LAD, LCX, RCA, ramus intermedius) or a branch of the major coronary artery (LAD, LCX, RCA).
| 0913T | Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) when performed, imaging supervision, interpretation, and report, single major coronary artery or branch |
Code 0914T, however, is an add-on code. This code encompasses PCI utilizing drug-eluting or drug-coated angioplasty and includes mechanical dilation with a non-drug delivery balloon and IVUS or OCT, when performed. It is important to note this add-on code is reported when performed on a separate target lesion in addition to the primary intervention in the same major coronary artery or graft (left main, LAD, LCX, RCA, ramus intermedius) or a branch of the major coronary artery (LAD, LCX, RCA).
| +0914T | Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with balloon angioplasty, coronary stent placement or coronary atherectomy, including mechanical dilation by nondrug-delivery balloon angioplasty, endoluminal imaging using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) when performed, imaging supervision, interpretation, and report, single major coronary artery or branch (List separately in addition to code for percutaneous coronary stent or atherectomy intervention) |
For accurate coding, coders must hold a clear understanding of the procedure itself. Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-coated balloon (DCB) is a minimally invasive procedure used to treat coronary artery disease (CAD). It involves using a specialized balloon catheter to deliver antiproliferative drugs directly to the site of a narrowed or blocked coronary artery during percutaneous coronary interventions (PCI). This approach can be combined with other interventions aimed at restoring blood flow to the heart. DCBs provide long-term vessel patency and may offer comparable outcomes to drug-eluting stents (DES) without the need for permanent implants, making them a valuable option, particularly for in-stent restenosis cases.
With every dollar of reimbursement counting more than ever in the face of payment decline and complex new rules, it’s imperative to make sure your CPT® coding is correct and compliant. Master more cardiology coding topics and break down the complexity with our Cardiology All Access Pass. Find the right subscription and resource tailored to your needs today to make every member of your team successful with 2025 coding.
Today is Mardi Gras, which is French for “Fat Tuesday.” It is the last day before lent starts tomorrow, Ash Wednesday. This got me thinking
EDITOR’S NOTE: The narrative in this article reflects the firsthand perspectives and professional experience of Tami McMasters Gomez, curated and prepared for publication by Penny
Please log in to your account to comment on this article.
Sepsis sequencing continues to challenge even experienced coding and CDI professionals, with evolving guidelines, documentation gaps, and payer scrutiny driving denials and data inconsistencies. In this webcast, Payal Sinha, MBA, RHIA, CCDS, CDIP, CCS, CCS-P, CCDS-O, CRC, CRCR, provides clear guideline-based strategies to accurately code sepsis, severe sepsis, and septic shock, assign POA indicators, clarify the relationship between infection and organ dysfunction, and align documentation across teams. Attendees will gain practical tools to strengthen audit defensibility, improve first-pass accuracy, support appeal success, reduce denials, and ensure accurate quality reporting, empowering organizations to achieve consistent, compliant sepsis coding outcomes.
Expert presenters Kathy Pride, RHIT, CPC, CCS-P, CPMA, and Brandi Russell, RHIA, CCS, COC, CPMA, break down complex fracture care coding rules, walk through correct modifier application (-25, -57, 54, 55), and clarify sequencing for initial and subsequent encounters. Attendees will gain the practical knowledge needed to submit clean claims, ensure compliance, and stay one step ahead of payer audits in 2026.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
