CPT Code 92920 – A Complete Guide to Coronary Stent Coding
CPT code 92920 is used for coronary stent placement during cardiac catheterization, including imaging guidance and angioplasty are performed. Proper medical coding requires vessel-specific modifiers (LD, LC, RC) and bundling rules—angiography (93458) should not be billed separately unless done in a distinct session.
Reimbursement averages 1,200–2,500, with Medicare paying around $1,500 (facility + physician fees). To avoid denials, document stent type, vessel location, and complications, and use 92921 + Modifier 59 for additional stents.
Always check payer policies; prior authorization is often required for this critical interventional cardiology procedure.
What Is CPT Code 92920?
CPT 92920 covers Trans catheter placement of intracoronary stent(s) with imaging guidance. Used in angioplasty to treat blocked arteries, it includes supervision, interpretation, and report. Critical for cardiac cath lab billing Services.
CPT Code 92920 Explained
Procedure Details
- Purpose:Â Treat coronary artery blockages via stent placement during cardiac catheterization.
- Included Services:
- Trans catheter stent deployment.
- Balloon angioplasty (if performed).
- Imaging guidance (fluoroscopy) and supervision.
- Pre- and post-dilation assessments.
Key Restrictions:
- Bundled Services: Do not separately bill for angiography (e.g., 93458) performed during the same session.
- Modifiers Required: Use LD (left anterior descending artery) or LC (left circumflex) for specific vessel stenting.
Coding Guidelines & Reimbursement
When to Use 92920 vs. Similar Codes
- 92920:Â Single stent placement in one coronary artery.
- 92921: Each additional stent in the same vessel (append modifier 59).
- 92928: Coronary Thrombectomy procedure – report this along with 92920 if clot removal is performed.
Modifiers
- LD/LC/RC:Â Specify stented vessel (e.g., LD for left anterior descending).
- 59: Distinct procedural service (e.g., a stent in a separate vessel).
- No Modifier Needed for a standalone 92920 in a single vessel.
Reimbursement
- Average Cost: 1,200–1,200–2,500 (facility + physician fees).
- Medicare Payment:Â ~900(facility)+Â 900(facility)+Â 600 (professional).
- Bundling Rules: Angiography (93458) and stent placement (92920) are not billed together.
Documentation Requirements
- Indicate stent type (drug-eluting vs. bare-metal).
- Specify vessel(s) treated (e.g., LC, RCA).
- Note complications (e.g., dissection, no-reflow).
Conclusion
CPT 92920 is vital for interventional cardiology billing.Â
Key takeaways:
- Use vessel-specific modifiers (LD/LC/RC).
- Bundle angiography and stent placement.
- Document stent type and procedural details.
Frequently Asked Questions (FAQs)
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1. Can I bill 92920 with 93458 (angiography)?
No—angiography is included in 92920. Use 93458 only if performed separately (e.g., diagnostic cath pre-stent).
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2. What modifier is needed for multiple stents?
Use 92921 + 59 for each additional stent in the same session.
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3. Does 92920 require prior authorization?
Often yes—check insurers like Medicare or commercial payers for CAD coverage policies.
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4. What’s the difference between 92920 and 92928?
- 92920:Â Stent placement.
- 92928:Â Thrombectomy (clot removal).
