Anthem Blue Cross and Blue Shield | CommercialDecember 30, 2022
Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List
As previously communicated in the December 2022 edition of Provider News, AIM Specialty Health® (AIM)* will apply additional code updates to the AIM Diagnostic Coronary Angiography and Percutaneous Coronary Intervention Clinical Appropriateness Guidelines. That code update expansion has been delayed. The codes listed below will go into effect April 1, 2023, not February 1, 2023, as originally communicated.
Percutaneous coronary intervention:
CPT code | Description |
92975 | Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography |
C1714 | Catheter, transluminal atherectomy, directional |
C1724 | Catheter, transluminal atherectomy, rotational |
C1725 | Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability) |
C1753 | Catheter, intravascular ultrasound |
C1760 | Closure device, vascular (implantable/insertable) |
C1761 | Catheter, transluminal intravascular lithotripsy, coronary |
C1769 | Guide wire |
C1874 | Stent, coated/covered, with delivery system |
C1875 | Stent, coated/covered, without delivery system |
C1876 | Stent, non-coated/non-covered, with delivery system |
C1877 | Stent, non-coated/non-covered, without delivery system |
C1885 | Catheter, transluminal angioplasty, laser |
C1887 | Catheter, guiding (may include infusion/perfusion capability) |
C9600 | Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch |
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) |
C9602 | Percutaneous transluminal coronary atherectomy, with drug eluting intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch |
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) |
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 |
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) |
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 |
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) |
- Access AIM’s ProviderPortalSM directly at providerportal.com:
- Online access is available 24/7 to process orders in real-time and is the fastest and most convenient way to request authorization.
- Call the AIM Contact Center toll-free number at 800-714-0040, Monday through Friday, from 7 a.m. to 7 p.m. Central
If you have questions related to guidelines, contact AIM via email at aim.guidelines@aimspecialtyhealth.com. Additionally, you may access and download a copy of the current and upcoming guidelines here.
* AIM Specialty Health is an independent company providing some utilization review services on behalf of the health plan.
MULTI-BCBS-CM-015066-22-CPN14827
PUBLICATIONS: January 2023 Provider Newsletter - Maine
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