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CPT®
0291T

CPT® Code 0291T

Official Description

Intravascular optical coherence tomography (coronary native vessel or graft) during diagnostic evaluation and/or therapeutic intervention, including imaging supervision, interpretation, and report; initial vessel (List separately in addition to primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Intravascular optical coherence tomography (OCT) is a sophisticated imaging technique utilized within the coronary arteries, specifically designed to provide detailed microstructural information about atherosclerotic plaques. This catheter-based modality employs infrared light waves that penetrate the arterial walls, reflecting off internal biological tissues to generate high-resolution images. These images are crucial for characterizing various components of atherosclerotic plaques, particularly in identifying vulnerable plaques that are deemed unstable and at a heightened risk of rupture. Such ruptures can lead to significant cardiovascular events, making the assessment of these plaques vital in clinical practice. Intravascular OCT is not only instrumental in evaluating plaque stability but also serves as an adjunctive tool during stent placement procedures and for follow-up assessments after stent implantation. The procedure encompasses several key elements, including the supervision of OCT imaging, interpretation of the findings, and the generation of a comprehensive written report. To accurately report the initial vessel assessed using this advanced imaging technique, medical coders should utilize CPT® code 0291T, while code 0292T should be employed for any additional vessels evaluated during the same session.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Intravascular optical coherence tomography (OCT) is indicated for use in various clinical scenarios, particularly in the context of coronary artery disease. The following conditions and situations warrant the application of this imaging technique:

  • Assessment of Atherosclerotic Plaques Intravascular OCT is utilized to evaluate the microstructural characteristics of atherosclerotic plaques, particularly to identify vulnerable plaques that may pose a risk of rupture.
  • Stent Placement The procedure is performed as an adjunct to stent placement, providing critical imaging that aids in the accurate positioning and deployment of stents within the coronary arteries.
  • Follow-Up Evaluations Intravascular OCT is also employed for follow-up assessments post-stent placement, allowing for the monitoring of stent patency and the evaluation of any changes in the arterial structure over time.

2. Procedure

The procedure for intravascular optical coherence tomography involves several key steps that ensure accurate imaging and assessment of the coronary arteries. The following outlines the procedural steps:

  • Step 1: Catheter Insertion A catheter is carefully inserted into the coronary artery through a percutaneous access point, typically in the femoral or radial artery. This catheter is equipped with an optical imaging device that will be used to perform the OCT.
  • Step 2: Imaging Supervision During the procedure, the physician supervises the imaging process, ensuring that the catheter is correctly positioned within the target vessel. This supervision is critical for obtaining high-quality images of the arterial walls and plaques.
  • Step 3: OCT Imaging The OCT device emits infrared light waves that penetrate the arterial tissue. As these light waves reflect off the internal structures, high-resolution images are generated, allowing for detailed visualization of the atherosclerotic plaques and surrounding tissues.
  • Step 4: Interpretation of Findings After the imaging is completed, the physician interprets the obtained images, analyzing the characteristics of the plaques and assessing their stability. This interpretation is essential for determining the appropriate clinical management.
  • Step 5: Report Generation A comprehensive written report is created, summarizing the findings from the OCT imaging. This report includes details about the condition of the plaques, any identified vulnerabilities, and recommendations for further treatment or intervention if necessary.

3. Post-Procedure

Following the intravascular optical coherence tomography procedure, patients may be monitored for any immediate complications related to catheter insertion or the imaging process. It is essential to assess the access site for bleeding or hematoma formation. Patients may also undergo further evaluation based on the findings from the OCT report, which could include additional therapeutic interventions or adjustments to their current treatment plan. The recovery period is typically brief, but patients should be advised on any specific post-procedure care instructions provided by their healthcare team, including activity restrictions and follow-up appointments to discuss the results and next steps in their care.
Short Descr IV OCT FOR PROC INIT VESSEL
Medium Descr INTRAV OPTCL CHERNCE TMGRPHY W/S&I INTL VESL
Long Descr Intravascular optical coherence tomography (coronary native vessel or graft) during diagnostic evaluation and/or therapeutic intervention, including imaging supervision, interpretation, and report; in
Status Code Carriers Price the Code
Global Days ZZZ - Code Related to Another Service
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Items and Services Packaged into APC Rates
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) P4E - Eye procedure - other
MUE Not applicable/unspecified.
CCS Clinical Classification 62 - Other diagnostic cardiovascular procedures
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2016-12-31 Deleted Code deleted. See 92978, 92979.
2013-01-01 Added First appearance in code book
2013-01-01 Changed Guideline information changed.
2012-01-01 Added Added
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