Any major coronary artery or one of its branches may be evaluated with (and coded for) intravascular ultrasound (IVUS) or IFR/FFR

Q.

Can anyone tell me if a cardiac branch, say the first diagonal branch, can be coded if it is the only vessel in which IVUS or IFR/FFR was performed?

A.

Yes, if a major coronary artery or one of its branches is evaluated with intravascular ultrasound (IVUS) or IFR/FFR, then CPT code 93571 may be reported. 

The codes and full descriptions are as follows:

93571 Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (List separately in addition to code for primary procedure)

93572 Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; each additional vessel (List separately in addition to code for primary procedure)

In our opinion, 93571 may be reported once within a coronary artery family. If fractional flow reserve (FFR) is performed in the LAD and a diagonal branch, then report 93571 only. If instantaneous wave-free ratio (IFR) is performed in the diagonal branch (without also performing it in the LAD), you would still code 93571 (with modifier 52 since it is IFR and not FFR).

If you perform IFR in the LAD or one of its branches and in the RC or one of its branches, you would report 93571-52 and 93972-52.