CPT code 92929 is used for an additional procedure involving a coronary artery stent placement with angioplasty.
CPT code 92929 is used to describe the procedure of placing an additional coronary stent with angioplasty. This code is specifically for each additional vessel beyond the first one treated during the same session. It involves the insertion of a stent, which is a small, expandable tube, into a coronary artery to help keep it open and improve blood flow to the heart. The procedure is typically performed using a catheter and is guided by imaging techniques to ensure precise placement. This code is used in conjunction with the primary procedure code for the initial stent placement.
For CPT code 92929, which involves percutaneous coronary intervention procedures, several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, typically when the procedure is performed in a facility setting.
2. Modifier 59 - Distinct Procedural Service: Applied to indicate that a procedure or service was distinct or independent from other services performed on the same day. This is particularly relevant if multiple procedures are performed and need to be distinguished from one another.
3. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician on the same day.
4. Modifier 77 - Repeat Procedure by Another Physician: Applied when the same procedure is repeated by a different physician on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used when the patient returns to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Applied when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
7. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Although less common for this type of procedure, it may be used if a diagnostic test is repeated for clinical reasons.
8. Modifier XS - Separate Structure: Indicates that a service was performed on a separate organ/structure.
9. Modifier XE - Separate Encounter: Used to denote a service that is distinct because it occurred during a separate encounter.
10. Modifier XP - Separate Practitioner: Indicates that a service was performed by a different practitioner.
11. Modifier XU - Unusual Non-Overlapping Service: Used to describe a service that does not overlap usual components of the main service.
These modifiers help clarify the specifics of the procedure performed and ensure accurate billing and reimbursement. It is crucial to use the appropriate modifiers to avoid claim denials and ensure compliance with payer policies.
CPT code 92929 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare, along with the payment rates for each service. However, the actual reimbursement for CPT code 92929 can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national Medicare policies and set local coverage determinations, which can influence whether and how much a particular service is reimbursed. Therefore, healthcare providers should consult their specific MAC for detailed information on reimbursement for CPT code 92929.
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