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Endoluminal imaging of coronary vessels or grafts is a critical procedure that utilizes advanced technologies such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT) to provide detailed visual assessments of the coronary arteries or bypass grafts. This imaging is performed during diagnostic evaluations or therapeutic interventions, allowing healthcare professionals to gain insights into the condition of the blood vessels from within. IVUS employs a miniaturized transducer to create cross-sectional images of the vessel, revealing its structural layers, including the outer adventitia, the media, the intima, and the lumen where blood flows. On the other hand, OCT utilizes near-infrared light to generate high-resolution, three-dimensional images, offering superior detail in identifying smaller dimensions within the lumen and assessing the extent of atherosclerotic plaque buildup or the tissue response to grafting. The procedure involves advancing an IVUS or OCT catheter over a guidewire to the targeted area for evaluation, followed by the physician's interpretation of the images and the generation of a comprehensive report. It is important to note that CPT® Code 92979 is specifically designated for each additional vessel imaged beyond the primary procedure, which is reported using CPT® Code 92978.
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The endoluminal imaging of coronary vessels or grafts using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) is indicated for various clinical scenarios, particularly during diagnostic evaluations and therapeutic interventions. The following conditions may warrant the use of this imaging technique:
The procedure for endoluminal imaging of coronary vessels or grafts involves several key steps that ensure accurate and effective evaluation. The following outlines the procedural steps:
After the endoluminal imaging procedure, patients are typically monitored for any immediate complications, such as bleeding or vascular access site issues. Depending on the patient's condition and the complexity of the procedure, they may be observed in a recovery area for a specified period. Instructions regarding activity restrictions, medication management, and follow-up appointments are provided to ensure optimal recovery and ongoing care. The physician will discuss the findings from the imaging report with the patient and outline any necessary next steps based on the results.
| Short Descr | ENDOLUMINL IVUS OCT C EA | Medium Descr | ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL | Long Descr | Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; each additional vessel (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) | 1 - Diagnostic Tests for Radiology Services | 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) | 4 - Diagnostic Radiology | Berenson-Eggers TOS (BETOS) | I3C - Echography/ultrasonography - heart | MUE | 2 | CCS Clinical Classification | 193 - Diagnostic ultrasound of heart (echocardiogram) |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 92978 | Addon Code CPT Resequenced MPFS Status: Carrier Priced APC N ASC N1 CPT Assistant Article Illustration for Code Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure) |
| 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. | LD | Left anterior descending coronary artery | LC | Left circumflex coronary artery | LM | Left main coronary artery | RC | Right coronary artery | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | RI | Ramus intermedius coronary artery | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 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). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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). | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | 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 | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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Action
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Notes
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| 2020-01-01 | Note | AMA Guidelines changed. |
| 2017-01-01 | Changed | Long, Medium and Short descriptions changed. Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Added another guideline |
| 2011-01-01 | Changed | Short description changed. |
| 1997-01-01 | Added | First appearance in code book in 1997. |
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