CMS Pub. 100-04, ch. 4, § 61.5

Since CY 2003, under the OPPS, we assign coronary stent placement procedures to

separate APCs based on the use of nondrug- eluting or drug- eluting stents (APC 0104

(Transcatheter Placement of Intracoronary Stents) or APC 0656 (Transcatheter Placement

of Intracoronary Drug-Eluting Stents), respectively). In order to effectuate this policy, we

created HCPCS G-codes G0290 (Transcatheter placement of a drug eluting intracoronary

stent(s), percutaneous, with or without other therapeutic intervention, any method; single

vessel) and G0291 (Transcatheter placement of a drug eluting intracoronary stent(s),

percutaneous, with or without other therapeutic intervention, any method; each additional

vessel) for drug -eluting intracoronary stent placement procedures that pa rallel existing

CPT codes 92980 (Transcatheter placement of an intracoronary stent(s), percutaneous,

with or without other therapeutic intervention, any method; single vessel) and 92981

(Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other

therapeutic intervention, any method; each additional vessel), which are used to describe

nondrug-eluting intracoronary stent placement procedures. For CY 2012 and years prior,

CPT codes 92980 and 92981 have been assigned to APC 0104, while HCPCS codes G0290

and G0291 have been assigned to APC 0656.

Effective January 1, 2013, the AMA’s CPT Editorial Panel is deleting CPT codes 92980

and 92981 and replacing them with the following new CPT codes:

• CPT code 92928 (Percutaneous transcatheter placement of intracoronary stent(s),

with coronary angioplasty when performed; single major coronary artery or

branch)

• CPT code 92929 (Percutaneous transcatheter placement of intracoronary stent(s),

with coronary angioplasty when performed; each additional branch of a major

coronary artery (List separately in addition to code for primary procedure));

• CPT code 92933 (Percutaneous transluminal coronary atherectomy, with

intracoronary stent, with coronary angioplasty when performed; single major

coronary artery or branch);

• CPT code 92934 (Percutaneous transluminal coronary atherectomy, with

intracoronary stent, with coronary angioplasty when performed; each additional

branch of a major coronary artery (List separately in addition to code for primary

procedure));

• CPT code 92937 (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);

• CPT code 92938 (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; each additional branch subtended by the bypass graft

(List separately in addition to code for primary procedure));

• CPT code 92941 (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);

• CPT code 92943 (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); and

• CPT code 92944 (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; each

additional coronary artery, coronary artery branch, or bypass graft (List separately

in addition to code for primary procedure)).

In order to maintain the existing policy of differentiating payment for intracoronary stent

placement procedures involving nondrug-eluting and drug-eluting stents, we are deleting

HCPCS codes G0290 and G0291 and replacing them with the following new HCPCS C-

codes to parallel the new CPT codes:

• HCPCS code C9600 (Percutaneous transcatheter placement of drug eluting

intracoronary stent(s), with coronary angioplasty when performed; single major

coronary artery or branch);

• HCPCS code C9601 (Percutaneous transcatheter placement of drug-eluting

intracoronary stent(s), with coronary angioplasty when performed; each

additional branch of a major coronary artery (List separately in addition to code

for primary procedure));

• HCPCS code C9602 (Percutaneous transluminal coronary atherectomy, with drug

eluting intracoronary stent, with coronary angioplasty when performed; single

major coronary artery or branch);

• HCPCS code C9603 (Percutaneous transluminal coronary atherectomy, with

drug-eluting intracoronary stent, with coronary angioplasty when performed; each

additional branch of a major coronary artery (List separately in addition to code

for primary procedure));

• HCPCS code C9604 (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);

• HCPCS code C9605 (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; each additional branch subtended by

the bypass graft (List separately in addition to code for primary procedure));

• HCPCS code C9606 (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);

• HCPCS code C9607 (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); and

• HCPCS code C9608 (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; each additional coronary artery, coronary artery branch, or bypass

graft (List separately in addition to code for primary procedure)).

CPT codes 92928, 92933, 92929, 92934, 92937, 92938, 92941, 92943, and 92944 should

be used to describe nondrug-eluting intracoronary stent placement procedures and are

assigned to APC 0104. HCPCS codes C9600, C9601, C9602, C9603, C9604, C9605,

C9606, C9607, and C9608 are assigned to APC 0656.