ACC-SCAI’s Refreshed Coding Recommendation for RFR (Resting Full-Cycle Ratio) and resting FFR (Pd/Pa without hyperemia)

Q: RFR and Resting FFR are non-hyperemic indices that do NOT require the step of administering a pharmacological stress agent, like FFR. The code descriptors for the existing FFR codes (93571, 93572) specifically state that pharmacological induced stress is included. What would be the appropriate way to code an FFR procedure that did not involve pharmacological induced stress?

A: The preponderance of the work associated with RFR and resting FFR (or Pd/Pa without hyperemia) is similar enough to be considered performing an FFR study. Therefore, the existing codes are applicable - however, as the existing codes specifically state that the work of pharmacological induced stress is included, for those cases not involving pharmacological induced stress, modifier -52, signifying a “reduced level” of service has been provided is to be appended to the applicable existing FFR code(s) (93571, 93572).