CPT code 92933 is used for procedures involving the placement of a stent in a coronary artery, often combined with atherectomy and angioplasty.
CPT code 92933 is used to describe a percutaneous coronary intervention that involves the placement of a stent, along with atherectomy and angioplasty, in a single coronary artery or branch. This code is typically utilized when a healthcare provider performs a procedure to open a narrowed or blocked coronary artery using a combination of techniques: inserting a stent to keep the artery open, removing plaque through atherectomy, and widening the artery with angioplasty. This comprehensive approach is often necessary to restore adequate blood flow to the heart muscle, thereby improving cardiac function and reducing symptoms such as chest pain.
For CPT code 92933, which involves percutaneous coronary intervention procedures, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: This modifier is used when the service provided is the professional component only, such as the interpretation of diagnostic tests.
2. Modifier 50 - Bilateral Procedure: If the procedure is performed on both sides of the body, this modifier indicates that it was a bilateral procedure.
3. Modifier 51 - Multiple Procedures: This modifier is used when multiple procedures are performed during the same session. It helps indicate that the procedure is one of several performed.
4. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 62 - Two Surgeons: When two surgeons work together as primary surgeons performing distinct parts of a procedure, this modifier is applicable.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is used when the same procedure is repeated by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used when the same procedure is repeated by a different physician on the same day.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room: This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: This modifier is used when an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier 80 - Assistant Surgeon: This modifier is used when an assistant surgeon is required for the procedure.
11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): This modifier is used when an assistant surgeon is necessary, and a qualified resident surgeon is not available.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
CPT code 92933 is reimbursed by Medicare, but the reimbursement is subject to several factors. The Medicare Physician Fee Schedule (MPFS) determines the payment rates for services covered under Medicare Part B, including those associated with CPT code 92933. The reimbursement amount can vary based on geographic location and other factors, as determined by the MPFS.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in the reimbursement process. MACs are responsible for processing Medicare claims and have the authority to establish local coverage determinations (LCDs) that may affect the reimbursement of specific CPT codes, including 92933. Providers should verify with their respective MACs to ensure compliance with any local policies or requirements that might impact reimbursement for this code.
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