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The CPT® Code 92974 refers to the transcatheter placement of a radiation delivery device specifically designed for subsequent coronary intravascular brachytherapy. This procedure is performed in conjunction with a cardiac catheterization, which is a separate and reportable procedure. The primary purpose of this intervention is to address issues related to primary coronary stenosis or to manage restenosis that may occur following the placement of a coronary artery stent. During the procedure, a guidewire is initially placed within the coronary artery, which serves as a pathway for the catheter that carries the brachytherapy delivery device. This device is essentially a wire, often referred to as a seed train or ribbon, that is imbued with radiation. Once the catheter is accurately positioned at the site of the stenosis, the radiation is delivered to the affected area to help inhibit the growth of tissue that could lead to further narrowing of the artery. After the radiation treatment is administered, both the brachytherapy delivery device and the catheter are removed. Following this, the physician may proceed with additional therapeutic interventions, such as angioplasty, atherectomy, or stenting, to further treat the coronary artery stenosis or restenosis, ensuring comprehensive management of the patient's condition.
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The transcatheter placement of a radiation delivery device for subsequent coronary intravascular brachytherapy is indicated for the following conditions:
The procedure for transcatheter placement of the radiation delivery device involves several critical steps:
Post-procedure care following the transcatheter placement of the radiation delivery device typically involves monitoring the patient for any immediate complications related to the catheterization and radiation delivery. Patients may be observed for signs of bleeding, infection, or other adverse reactions. Additionally, the physician will provide instructions regarding activity restrictions and follow-up appointments to assess the effectiveness of the treatment and monitor for any recurrence of stenosis. It is essential for patients to adhere to prescribed medications and lifestyle modifications to support recovery and cardiovascular health.
| Short Descr | CATH PLACE CARDIO BRACHYTX | Medium Descr | TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX | Long Descr | Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure) | Status Code | Active 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 | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P7A - Oncology - radiation therapy | MUE | 1 | CCS Clinical Classification | 67 - Other therapeutic procedures, hemic and lymphatic system |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 92920 | Resequenced Code MPFS Status: Active Code APC J1 ASC J8 Percutaneous transluminal coronary angioplasty; single major coronary artery or branch | 92924 | Resequenced Code MPFS Status: Active Code APC J1 Percutaneous transluminal coronary atherectomy, with coronary angioplasty when performed; single major coronary artery or branch | 92928 | Resequenced Code MPFS Status: Active Code APC J1 ASC J8 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch | 92933 | Resequenced Code MPFS Status: Active Code APC J1 Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch | 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 | 92941 | Resequenced Code MPFS Status: Active Code APC C Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel | 92943 | Resequenced Code MPFS Status: Active Code APC J1 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel | 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 | C9600 | Medicare Coverage: Special Coverage Instructions APC J1 ASC J8 Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch | C9602 | Medicare Coverage: Special Coverage Instructions APC J1 Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch | 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 | C9606 | Medicare Coverage: Special Coverage Instructions APC C Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel | C9607 | Medicare Coverage: Special Coverage Instructions APC J1 Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel |
| RC | Right coronary artery | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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 | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RI | Ramus intermedius coronary artery | 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 | Changed | Guideline information changed. |
| 2011-01-01 | Changed | Short description changed. Guideline information changed. |
| 2002-01-01 | Added | First appearance in code book in 2002. |
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