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The procedure described by CPT® Code 92938 involves the percutaneous transluminal revascularization of a coronary artery bypass graft that may be constructed from internal mammary arteries, free arterial grafts, or venous grafts. This complex intervention is performed to restore blood flow in cases where the bypass graft has become occluded or narrowed due to stenosis. The revascularization process can include a combination of techniques such as angioplasty, atherectomy, and the placement of intracoronary stents. The procedure is typically initiated by accessing the femoral artery, where the skin is prepped and punctured to insert a sheath. A guidewire is then navigated through the vascular system to reach the affected bypass graft. The physician evaluates the graft using a catheter and may employ a distal embolic protection device to prevent debris from traveling downstream during the intervention. Angioplasty involves inflating a balloon at the site of the blockage to compress plaque against the arterial wall, while atherectomy utilizes a specialized device to shave away plaque. If necessary, a stent may be deployed to maintain the artery's patency. Following the intervention, completion angiography is performed to confirm the success of the procedure, and appropriate post-procedure care is administered to the vascular access site.
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The procedure described by CPT® Code 92938 is indicated for patients with occluded or stenosed coronary artery bypass grafts. The following conditions may warrant this intervention:
The procedure for CPT® Code 92938 involves several critical steps to ensure successful revascularization of the coronary artery bypass graft:
Post-procedure care for patients undergoing CPT® Code 92938 includes monitoring for any complications such as bleeding or hematoma at the access site. Patients may be advised to rest and limit physical activity for a specified period. Follow-up appointments are typically scheduled to assess the success of the procedure and to monitor the condition of the bypass graft. Additionally, patients may require medication adjustments or further interventions based on their recovery and overall cardiovascular health.
| Short Descr | PRQ REVASC BYP GRAFT ADDL | Medium Descr | PRQ TRLUML CORONARY BYP GRFT REVASC ADDL VESSEL | Long Descr | 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) | Status Code | Bundled Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 9 - Not Applicable | Multiple Procedures (51) | 9 - Concept does not apply. | Bilateral Surgery (50) | 9 - Concept does not apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 9 - Concept does not apply. | Co-Surgeons (62) | 9 - Concept does not apply. | Team Surgery (66) | 9 - Concept does not apply. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 2 | CCS Clinical Classification | 45 - Percutaneous transluminal coronary angioplasty (PTCA) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 92937 | Resequenced Code MPFS Status: Active Code APC J1 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 | Medicare Coverage: Special Coverage Instructions APC J1 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 |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LC | Left circumflex coronary artery | LD | Left anterior descending coronary artery | LM | Left main coronary artery | RC | Right coronary artery | RI | Ramus intermedius coronary artery | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Added | Added |
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