Cardiology Question for the Week of September 18, 2023

Question:

What is an acceptable base code to pair with add-on code 0715T– Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure)?

Answer:

Per the CPT® book, the parenthetical entry directly under code 0715T indicates that this code is used in conjunction with CPTs 92920, 92924, 92928, 92933, 92937, 92941, 92943, and 92975. This listing of codes includes services performed with atherectomy, stent, or angioplasty in combination or used alone.It is important to point out that while the CPT code book indicates that an angioplasty, atherectomy, or graft PCI service alone (ie. CPTS 92920, 92924, 92937) are acceptable base service codes to pair with +0715T, CMS Transmittal 10997 relates that for Hospital Outpatient Prospective Payment System, addition pass through payment for the intracoronary lithotripsy catheter (ie. HCPCS C1761) will only be award when the supply appears on the claim alongside CPT procedure codes 92928, C9600, 92933, 92943, C9602, C9607 only. Therefore hospitals should watch claims very closely that include the services of intracoronary lithotripsy paired with only an angioplasty, atherectomy, or graft PCI service used as a base code. As these claims may be rejected and require appeal with the rationale that at this time codes 92920, 92924, and 92937 are listed as acceptable base code pairs with +0715T per CPT 2023.

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