AHA Coding Clinic® for HCPCS - 2021 Issue 4; Ask the Editor

Instantaneous wave-free ratio (iFR) without pharmacologic stress agent

A patient with an abnormal coronary computed tomography angiography (CCTA) presents for a coronary angiography, an instantaneous wave-free ratio (iFR), and an intravascular ultrasound (IVUS). A left and right coronary artery angiography were performed. IVUS of the ostial left anterior descending artery (LAD) demonstrated non-significant disease. The iFR of the ostial/proximal LAD was negative. However, the iFR was performed without the administration of the pharmacologic stress agent. For facility reporting, is it appropriate to append modifier 52, Reduced Services or modifier 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration of Anesthesia, to CPT code 93571 for the iFR when the pharmacologic stress agent was not administered? ...

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