Cardiology Question for the Week of July 29, 2019

Question:

Regarding coronary intravascular ultrasound (IVUS), I understand if it is done prior to an intervention that we can bill it. It should be diagnostic, and the findings should document the vessel size and the medical necessity for performing the IVUS. Can I bill if it is done after an angioplasty to determine the size of stent that will be deployed? Our technical staff thinks that we should be charging these in addition to the stent.

Answer:

The code description for coronary IVUS changed in 2000 to allow its use during diagnostic evaluations or therapeutic interventions, so yes, it can be reported if IVUS is used to measure the vessel for stent sizing or to check to make sure the stent is in the correct position. The code is reported once per vessel regardless of the number of times IVUS is used in that vessel (e.g., during diagnostic evaluation, and then prior to stent placement, and again after stent placement). If additional vessels are evaluated with IVUS, 92979 is reported for each additional vessel.