On Demand: Coronary PCI in 2026: Navigating the New CPT Codes, Documentation Standards and Reimbursement Impacts-Webinar Recording

Video Transcription

Video Summary

This detailed webinar presentation focused on the upcoming 2026 coding updates for coronary percutaneous coronary interventions (PCI) and diagnostic cardiac catheterizations (cath). Jamie Quimby, MedAxium’s coding director, and consultant Linda Gates Striebe provided an in-depth overview of new procedure codes, documentation guidelines, and reimbursement impacts affecting cardiac cath and PCI services.<br /><br />The session began with a review of diagnostic cardiac caths, defining right heart, left heart, and coronary angiography procedures, along with common indications such as acute MI, angina, heart failure, and pulmonary hypertension. Documentation essentials were emphasized, including access points, catheter movements, pressures, and imaging findings to support medical necessity, especially in staged interventions. The presenters clarified coding distinctions among various cath types, including those involving bypass grafts, and highlighted Medicare’s strict guidelines on ultrasound guidance.<br /><br />The core focus was on significant 2026 PCI coding changes. Two new codes were introduced: one for complex stenting involving two or more distinct coronary lesions treated with multiple stents in separate segments, and one for chronic total occlusion (CTO) procedures using combined antegrade and retrograde approaches. The outdated additional lesion codes were removed, with the new structure designed to reflect lesion complexity more accurately. Detailed definitions distinguished between single versus distinct lesions, geographic separation, bifurcation lesions, and coronary segments referencing the ACC’s NCDR registry.<br /><br />Linda showcased procedural techniques critical for CTO coding, including antegrade wire escalation, retrograde approaches, dissection and re-entry methods, and dual injection angiography. She encouraged collaboration with physicians for precise documentation of techniques and anatomy to ensure correct code utilization. The presentation concluded emphasizing coder education for these nuanced updates, anticipated prior authorization challenges, and plans for early 2026 follow-up webinars to solidify understanding.

Keywords

2026 coding updates

coronary percutaneous coronary interventions

PCI

diagnostic cardiac catheterizations

cardiac cath

procedure codes

documentation guidelines

reimbursement impacts

complex stenting

chronic total occlusion

CTO procedures

Medicare guidelines

coder education