Percutaneous coronary intervention (PCI) performed during an acute myocardial infarction represents one of the most time-critical and life-saving procedures in cardiology. When PCI is performed during an acute MI — especially during a STEMI, within the global AMI window, or in the same vessel responsible for the infarct — the correct CPT code is 92941.
CPT 92941 is one of the highest complexity and highest reimbursement interventional cardiology codes. It is also one of the most heavily audited. Understanding when and how to use this code is critical for compliance, accurate reimbursement, and denial prevention. Stay compliant with complex procedural rules using our CPT 93460 Right & Left Heart Catheterization Billing Guide covering documentation, contrast use, and NCCI bundling.
This comprehensive guide explains everything you need to know about CPT 92941 — when to use it, what it includes, how it differs from other PCI codes, documentation rules, medical necessity, payer nuances, bundling, modifiers, ICD-10 pairing, and common denial reasons.
What Is CPT 92941?
Official CPT description:
“Percutaneous transluminal revascularization of acute myocardial infarction; single vessel.”
This describes PCI performed during an active acute MI, including:
- Balloon angioplasty
- Stent placement
- Atherectomy (if medically necessary)
- Mechanical thrombectomy (limited forms)
- Distal embolic protection (if used)
- Imaging guidance (supervision & interpretation)
In simple clinical terms:
CPT 92941 = PCI during acute MI (STEMI or ongoing infarction) to the infarct-related artery.
This includes work done:
- During a STEMI
- During an acute coronary occlusion causing infarction
- During the “global AMI window” (often 24–48 hours)
- When treating the culprit vessel responsible for the MI
What CPT 92941 Includes
Once CPT 92941 is used, it already includes several services:
1. Balloon Angioplasty (PTCA)
Inflation of a balloon to dilate the artery is included.
2. Stent Placement (Drug-eluting or Bare-metal)
All stent types are included — no separate code is needed.
3. Imaging Guidance
Fluoroscopy and interpretation are included. Master documentation and payer rules with our comprehensive CPT 93458 Left Heart Catheterization & Coronary Angiography Billing Guide
optimized for interventional cardiology practices.
4. Intravascular Embolic Protection (If Used)
Included when performed in the coronary arteries.
5. Thrombus Aspiration (Selective/Manual Thrombectomy)
Manual thrombectomy is included in 92941.
(Only large-bore mechanical thrombectomy has separate codes in peripheral vascular procedures — NOT coronary.)
6. The Entire Acute MI Workup and Urgent PCI Effort
CPT 92941 accounts for:
- Urgent activation
- Time-sensitive decision-making
- Additional risk
- Additional work complexity
These are all “baked into” the code.
What CPT 92941 Does NOT Include
Some services may still be billed separately when they occur:
1. PCI in a NON-infarct artery (different vessel)
Use add-on codes:
- 92921 (angioplasty in an additional vessel)
- 92925 (atherectomy add-on)
- 92929 (stent in additional vessel)
2. Intravascular ultrasound (IVUS)
- 92978 (initial vessel)
- 92979 (additional vessels)
3. Optical coherence tomography (OCT)
Often billed using IVUS codes, depending on the payer.
4. Diagnostic coronary angiography (if medically necessary)
Use 93452–93461, but ONLY when:
- No recent angiogram existed
- The diagnostic study was medically necessary
- The decision to perform PCI was based on the diagnostic findings
5. Moderate sedation
Often separately billable under 99152–99153.
When to Use CPT 92941
Use CPT 92941 when PCI is performed for an acute myocardial infarction in the culprit vessel.
Clinical criteria typically include:
STEMI (ST-Elevation MI)
- Inferior STEMI
- Anterior STEMI
- Lateral STEMI
- Posterior STEMI
NSTEMI With Active Infarction
If the patient is currently infarcting, emergent PCI is necessary.
Acute Coronary Thrombosis
When there is:
- 100% occlusion
- Fresh thrombus
- Ongoing ischemia
- Elevated troponin with EKG changes
Ongoing or Persistent Chest Pain With Infarction
Despite medical therapy.
Cardiogenic Shock
Emergent PCI in the culprit vessel during shock.
Ensure proper billing for in-clinic device evaluations using our CPT 93287 ICD/CRT-D In-Person Interrogation Billing Guide built to help cardiology teams maintain clean claims.
Life-Threatening Arrhythmias Due to Acute MI
Ventricular tachycardia or fibrillation requiring PCI.
STEMI Equivalent Conditions
Atypical presentations with:
- New LBBB
- Posterior MI
- Hyperacute T-waves
When NOT to Use CPT 92941
Do not bill 92941 in these scenarios:
❌ Stable angina PCI
Use 92928 or 92920, depending on stent vs angioplasty.
❌ NSTEMI without ongoing infarction
If PCI is NOT emergent → 92928 or similar codes.
❌ Elective PCI
92941 is ONLY for acute MI.
❌ PCI in a non-culprit artery during a MI
Still billable — but not under 92941.
Use:
- 92921, 92925, 92929 (additional-vessel add-on codes)
❌ PCI performed days after MI completion
Once the infarction is not “ongoing,” typical PCI codes apply.
Medical Necessity Requirements for CPT 92941
Payers require evidence that the PCI was performed during an active MI.
Documentation should include:
1. EKG Findings
- ST-elevation
- ST-depression
- Hyperacute T-waves
- New LBBB
- Reciprocal changes
2. Biomarkers
- Elevated troponin
- Rising biomarkers (delta positive)
3. Clinical Symptoms
- Chest pain
- Dyspnea
- Diaphoresis
- Syncope
- Hemodynamic instability
4. Angiographic Evidence
- Fresh thrombus
- Ulcerated plaque
- Total occlusion
- Culprit lesion identified
5. Urgency
Documentation should reflect emergent or urgent status — this is key.
Documentation Requirements
Required elements:
Indication
- STEMI / NSTEMI
- EKG results
- Troponin trends
- Onset of symptoms
- Failure of medical therapy
Procedure Description
Include:
- Vessel treated
- Lesion location
- Lesion severity (%)
- Device used (stent size/type)
- Balloon pressure
- Thrombus presence
- TIMI flow pre- and post-PCI
Complications (If Any)
e.g., no-reflow, arrhythmia, dissection.
Outcome
- Final TIMI flow
- Post-stent appearance
- Resolution of symptoms
Formal Report
Signed by the physician.
Prior Authorization Rules
Because this is an emergent, life-threatening service, prior authorization rules differ from routine PCI.
Medicare
- No prior authorization
- Documentation must reflect emergent MI care
Medicare Advantage
- PA not required for emergent situations
- Retro-auth may be required for claim processing
Commercial Plans
- No PA for emergent PCI
- Must document STEMI or active infarction
Medicaid
- Emergency PCI → no PA
- Non-emergent PCI → PA usually required
Reimbursement for CPT 92941
Approximate Medicare reimbursement:
- Facility: $7,000–$10,000
- Professional fee: $300–$450
Commercial insurance pays significantly higher.
Because of this high reimbursement, 92941 is also one of the most audited cardiology codes.
Improve accuracy and avoid interrogation denials with our CPT 93286 Loop Recorder In-Person Interrogation Billing Guide including coding, device checks, and setup requirements.
Common Denials & How to Avoid Them
❌ 1. MI is not documented clearly
Fix: Include EKG, troponin, chest pain, and infarct-related artery.
❌ 2. PCI was elective, not emergent
Fix: Clarify “acute MI,” “ongoing infarction,” or “emergent activation.”
❌ 3. Diagnostic cath was billed incorrectly
Fix: Bill angiography only if medically necessary.
❌ 4. The wrong code was used for non-culprit vessels
Fix: Use add-on codes, not 92941.
❌ 5. Missing physician interpretation
Fix: Include vessel anatomy, stenosis % measurement, and TIMI flow.
ICD-10 Codes Commonly Paired With 92941
- I21.01 – STEMI involving the left main
- I21.02 – STEMI of LAD
- I21.11 – STEMI of RCA
- I21.21 – STEMI of the circumflex
- I21.3 – STEMI, unspecified
- I21.4 – NSTEMI
- I24.9 – Acute ischemic heart disease, unspecified
- R07.9 – Chest pain
- I46.9 – Cardiac arrest
- I50.9 – Heart failure (when applicable)
Final Thoughts
CPT 92941 is one of the most important PCI codes in interventional cardiology. Because it represents high-acuity, high-risk, and high-reimbursement procedures, accurate documentation and correct coding are essential for compliance.
If your cardiology practice needs help reducing denials, auditing PCI documentation, or optimizing cath lab billing workflows, Global Tech Billing LLC provides specialized cardiology billing support to keep claims clean, compliant, and paid correctly.
Frequently Asked Questions (FAQ)
1. Can 92941 be billed with bypass graft PCI codes?
Yes — if bypass graft PCI is performed. Use:
- 92933 (atherectomy + stent)
- 92937 (bypass graft PCI)
2. Can I bill a diagnostic angiogram with 92941?
Yes — ONLY if:
- No recent study exists
- The diagnostic cath was medically necessary
- The PCI decision was based on new diagnostic findings
3. Is manual thrombectomy separately billable?
No — it is included.
4. Can PCI in another vessel be billed separately?
Yes — add-on codes are required.
Strengthen your remote device monitoring workflows using our detailed CPT 93272 Pacemaker & ICD Remote Monitoring Billing Guide covering documentation, technical components, and payer rules.
5. Does 92941 include moderate sedation?
No — separate codes 99152–99153 may be billed.
