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CPT® Code 0523T
Add-On Code

Official Description

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)

Common Language Description

Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping is a sophisticated technique utilized during coronary angiography to assess the hemodynamic significance of coronary artery lesions. This procedure involves the generation of a three-dimensional (3D) color-coded map that visually represents FFR values throughout the coronary tree. The FFR values are derived from data obtained during the coronary angiogram, allowing for real-time review and interpretation of potential atherosclerotic stenosis interventions. The primary goal of this mapping is to quantify the degree of atherosclerosis and vessel stenosis, which is crucial for optimizing percutaneous coronary interventions (PCI) and confirming the effectiveness of post-procedure revascularization. By integrating hemodynamic data with angiographic images, the FFR mapping software provides objective insights that assist physicians in making informed treatment decisions. The software connects seamlessly to the computer angiography system within the cardiac catheterization suite, ensuring that the 3D FFR color map is readily available for analysis on a dashboard display. This innovative approach enhances the precision of coronary interventions and contributes to improved patient outcomes.

Procedure Details

1. Indications

The intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping is indicated for the assessment of coronary artery disease, particularly in the following scenarios:

Assessment of Atherosclerosis This procedure is performed to evaluate the presence and severity of atherosclerotic lesions within the coronary arteries.
Quantification of Vessel Stenosis It is utilized to quantify the degree of stenosis in coronary vessels, aiding in the determination of the need for intervention.
Optimization of Percutaneous Coronary Intervention (PCI) The mapping assists in optimizing the approach and technique for PCI by providing real-time data on coronary flow dynamics.
Confirmation of Post-Procedure Revascularization After a PCI, this procedure helps confirm the effectiveness of the revascularization by assessing the FFR values post-intervention.

2. Procedure

The procedure for intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping involves several key steps:

Step 1: Data Acquisition During the coronary angiography, hemodynamic data is collected from the coronary arteries. This data is essential for calculating the FFR values, which reflect the pressure differences across a coronary stenosis.
Step 2: Integration with Angiographic Images The collected hemodynamic data is integrated with the angiographic images obtained during the procedure. This integration is crucial for creating an accurate representation of the coronary anatomy and the associated blood flow dynamics.
Step 3: 3D Mapping Generation The FFR mapping software processes the integrated data to generate a 3D color-coded map of the coronary tree. This map visually represents the FFR values at various epicardial locations, allowing for a comprehensive assessment of the coronary circulation.
Step 4: Real-Time Review The generated 3D FFR color map is displayed on a dashboard in the cardiac catheterization suite. Physicians can review this map in real-time, facilitating immediate decision-making regarding potential interventions for identified stenosis.

3. Post-Procedure

After the completion of the intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping, the physician will analyze the results to determine the necessity of any further interventions. The FFR values obtained will guide the treatment plan, which may include additional procedures such as balloon angioplasty or stenting if significant stenosis is identified. Patients may be monitored for any immediate complications related to the angiography or interventions performed. Follow-up care will be based on the overall clinical picture and the results of the FFR assessment, ensuring that any necessary adjustments to the treatment plan are made promptly.

Code Data Insights

Short Descr	NTRAPX C FFR W/3D FUNCJL MAP
Medium Descr	INTRAPROCEDURAL CORONARY FFP W/3D FUNCJL MAPPING
Long Descr	Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)
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	09 - 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
ASC Payment Indicator	Packaged service/item; no separate payment made.
Berenson-Eggers TOS (BETOS)	none
MUE	1

Add-On Codes

This is an add-on code that must be used in conjunction with one of these primary codes.

93454	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;
93455	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography
93456	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization
93457	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization
93458	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
93459	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
93460	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
93461	MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography

Modifier Assist

GC	This service has been performed in part by a resident under the direction of a teaching physician
Q1	Routine clinical service provided in a clinical research study that is in an approved clinical research study
26	Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
79	Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
LT	Left side (used to identify procedures performed on the left side of the body)
Q0	Investigational clinical service provided in a clinical research study that is in an approved clinical research study
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service

Chapter & Section Hierarchy

Personal Notes

Code History

Date	Action	Notes
2024-01-01	Changed	Guideline information changed.
2019-01-01	Added	Added

NCCI Crosswalk

Code	Description

59	Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. However, when another already established modifier is appropriate it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. Note: Modifier 59 should not be appended to an E/M service. To report a separate and distinct E/M service with a non-E/M service performed on the same date, see modifier 25.
79	Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional During the Postoperative Period: The individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. This circumstance may be reported by using modifier 79. (For repeat procedures on the same day, see modifier 76.)
LT	Left side (used to identify procedures performed on the left side of the body)
XU	Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
No matching codes found