CCSD code K4910 – Coronary angioplasty with stent insertion

Key takeaways

CCSD Code K4910 is a single code for PTCA plus coronary stent insertion via femoral or brachial access. Radial-access stenting is AA959, and balloon-only angioplasty is K4900.

Stent type (drug-eluting or bare metal) does not change the K4910 code. Payers may still apply different coverage or implant cost rules by stent type.

Most major UK PMI payers require prior authorisation before elective PCI under K4910. Missing pre-auth is the leading cause of claim denial for this procedure.

Pabau’s claims management tools help private cardiology practices track authorisation status, attach cath lab documentation, and submit clean K4910 claims to UK insurers.

What is CCSD Code K4910?

CCSD Code K4910 is the Clinical Coding and Schedule Development code for coronary angioplasty with stent insertion through femoral or brachial access. It is maintained by the CCSD Group as part of the UK private healthcare procedure schedule.

It covers inflating a balloon catheter inside a narrowed coronary artery to restore blood flow. A coronary stent is then deployed to hold the vessel open. K4910 applies only when both steps happen in the same procedure.

The code sits in the heart and cardiology section of the CCSD schedule. It is submitted to UK private medical insurers (PMI payers) when a consultant interventional cardiologist performs the procedure privately.

That may be at a private hospital or an independent sector treatment centre. The procedure is also referred to as percutaneous coronary intervention (PCI) with stenting, and the terms PTCA and PCI are used interchangeably in clinical practice.

Official descriptor

The official CCSD descriptor for K4910 is: Percutaneous transluminal angioplasty of coronary artery(ies) with stent insertion – femoral or brachial access.

This descriptor is the definitive reference for billing purposes. The access route is part of the code, so the same procedure via the radial artery is billed as AA959. Balloon angioplasty without a stent is K4900 (femoral or brachial) or AA957 (radial).

The procedure in clinical context

Percutaneous transluminal coronary angioplasty with stenting is performed by a consultant interventional cardiologist in a catheterisation laboratory (cath lab). It treats coronary artery disease, including stable angina, unstable angina and acute coronary syndrome. The balloon and stent mechanically relieve stenosis in one or more coronary arteries.

The procedural steps that must be documented to support a K4910 claim are:

1. Arterial access: Vascular access is established, typically via the radial or femoral artery, and a sheath is inserted. The route decides the code: femoral or brachial access is K4910, radial access is AA959.
2. Guide catheter placement: A guide catheter is advanced to the ostium of the affected coronary artery under fluoroscopic guidance.
3. Wire crossing: A coronary guidewire is passed through the stenosis in the target vessel.
4. Balloon dilation: An angioplasty balloon catheter is advanced over the wire and inflated at the stenosis site, compressing the plaque and restoring the vessel lumen.
5. Stent deployment: A coronary stent, either balloon-mounted or self-expanding, is positioned at the lesion site and deployed. This step is the defining element of K4910 over balloon-only angioplasty codes.
6. Post-dilation and imaging: The result is assessed by coronary angiography. Post-dilation with a non-compliant balloon may be performed to optimise stent expansion.

To satisfy insurers, the cath lab report must capture all six steps. That includes access route, vessel(s) treated, stent type and dimensions, balloon pressures, fluoroscopy time, and operator name.

What K4910 covers and what it excludes

K4910 is a procedural code with a defined scope. Queries often follow when billers fold extra services into the K4910 fee. They also follow when a separately billable code is left off the claim.

Drug-eluting vs bare metal stents: Does the type change the code?

No. K4910 does not differentiate between drug-eluting stents (DES) and bare metal stents (BMS), so both fall under the same procedural descriptor. DES make up the large majority of coronary stents used in UK PCI, according to the British Cardiovascular Intervention Society (BCIS) national audit.

Stent type still affects billing in three ways:

• Implant cost billing: Because DES carry a significant device cost premium over BMS, payers are more likely to have separate prosthesis policies for DES. Confirm with each insurer whether the stent implant cost is reimbursed within the K4910 procedure fee or must be submitted as a separate implant charge.
• Authorisation notes: Some payers request the stent type within the prior authorisation application, particularly for complex lesions where DES is clinically indicated over BMS. Document the rationale in the procedure report.
• Bioresorbable scaffolds: These remain uncommon in routine UK PCI. Check their status against the current CCSD schedule and the insurer’s guidance before billing one under K4910.

Related CCSD codes commonly billed alongside K4910

K4910 rarely stands alone in a private cardiology episode. Depending on what happened in the cath lab, an adjacent CCSD code either joins K4910 on the claim or replaces it. All codes below are taken from the February 2026 Bupa CCSD schedule.

Verify current code numbers and bundling rules against the live CCSD schedule before submission. Code numbers and their descriptors are subject to annual updates, and individual payer fee schedules may apply different unbundling policies. When a case fits none of these rows, our reference library helps you pick the right CCSD code.

K4910 vs similar CCSD codes: Avoiding coding errors

Most coding errors on PTCA claims come from the wrong stent status, access route, or level of complexity. The table below maps the key distinctions.

The single most common coding error is using K4910 when only balloon dilation was performed and no stent was left in place. Always confirm from the cath lab report whether a stent was deployed before selecting K4910.

Check the access route at the same time, because a radial case takes the AA-series code. The grid below puts both questions side by side.

OPCS-4 cross-reference for NHS and dual-coding environments

OPCS-4 (the Office of Population Censuses and Surveys Classification of Interventions and Procedures, Version 4) is the parallel coding system used in NHS inpatient settings. Cardiologists who work across NHS and private practice should understand how K4910 maps to OPCS-4. So should practices that use OPCS-4 as a verification reference.

In OPCS-4, stented coronary angioplasty sits in the K75 category (percutaneous transluminal balloon angioplasty and insertion of stent into coronary artery). The K49 category covers balloon angioplasty of coronary artery without a stent, and it explicitly excludes stent insertion.

Do not let the shared digits mislead you: CCSD K4910 does not map to OPCS-4 K49.1. The NHS Classifications Browser is the definitive tool for confirming current OPCS-4 sub-codes.

Private UK insurers do not accept OPCS-4 codes. They use CCSD. Note one difference: OPCS-4 separates drug-eluting from bare metal stents, while CCSD does not. The NHS Classifications Browser is free to use and helps when you cross-check procedure descriptions before a coding decision.

Prior authorisation requirements for K4910

Prior authorisation is required by all major UK private medical insurers for elective percutaneous coronary intervention. As a high-cost cardiac procedure, it is pre-authorised across every provider network.

Our Bupa CCSD billing guide covers the general pre-authorisation framework for Bupa-covered procedures in more detail.

Pre-authorisation rules change frequently. Always obtain written authorisation before performing elective PCI on a private patient, and retain the authorisation reference on the patient record. Emergency or urgent procedures performed without prior authorisation require retrospective notification to the insurer as soon as practicable. Timescales vary by payer.

Documentation required to support a K4910 claim

A clean K4910 claim depends on a complete cath lab report. Private practice billing teams should check the following documentation is available before submitting.

• Cath lab procedure report: Must name the vessel(s) treated, confirm stent deployment, and include stent type, dimensions (diameter and length), and balloon inflation pressures used.
• Fluoroscopy time and radiation dose: Required by many payers and by CQC-regulated private hospitals as part of the radiation record.
• Operator details: The name and GMC number of the consultant interventional cardiologist who performed the procedure.
• Stent device record: Stent lot number, manufacturer, and device dimensions – critical if the stent cost is to be billed as a separate prosthesis item.
• Pre-authorisation reference: The insurer’s authorisation number obtained before the procedure, attached to the claim submission.
• Diagnosis codes: The ICD-10 diagnosis code(s) supporting the intervention (e.g. I25.1 for atherosclerotic heart disease). Payers check these against the procedure code for clinical plausibility.
• Patient consent record: Signed informed consent for the procedure, including stent implantation and its associated risks.

Store procedure documentation and consent records in a system that links them to the matching claim. Payers can ask for supporting documents at any stage, and quick access shortens your reply to a query.

Why K4910 claims are denied and how to prevent it

Coronary stent claim denials follow a predictable pattern. Most are preventable with the right administrative processes in place. Claims management software that tracks authorisation status and flags incomplete documentation before submission removes the most common denial triggers at source.

Billing for multivessel or staged PCI under CCSD

Multivessel coronary artery disease is common in the private cardiology patient population. When more than one vessel requires stenting, coding and billing become more complex, and payer rules diverge. Find out how each insurer treats multivessel PCI before the procedure, rather than when the claim comes back.

Same-session multivessel stenting

When two or more vessels are stented in the same session, some payers accept K4910 claimed once per treated vessel. Others pay a single K4910 fee, however many vessels are treated. This is one of the most variable areas in UK private cardiology billing.

Before submitting a multi-vessel claim, contact the insurer’s provider team to confirm their position. Where permitted, name each treated vessel in the cath lab report (e.g. LAD and RCA, or LCx and RCA). Document stent dimensions separately for each vessel.

Staged PCI across separate sessions

In staged PCI, the interventional cardiologist treats one vessel at a first session and a second vessel later. This is more straightforward to bill. Each session generates its own K4910 claim, provided a fresh prior authorisation is obtained for each admission. The payer will treat each session as a separate episode.

Document clearly in the clinical notes that the second procedure is a planned staged intervention, naming the vessel(s) treated at each session. Payers may query a second K4910 submission if the documentation does not clearly distinguish it from the first episode.

How Pabau keeps K4910 claims clean from cath lab to payment

In many private cardiology practices, the authorisation number sits in an email and the cath lab report in the hospital system. The stent device record is often on paper. The claim goes out without one of them, and the insurer sends a query weeks later.

Pabau, the practice management and billing platform we build, keeps those pieces on one patient record. Insurance details and the authorisation reference sit on the client card. Signed consent and procedure documents attach to the episode. Claims go to Bupa, AXA Health, Vitality, Aviva and WPA through Healthcode.

Your billing team can check Bupa cover before the procedure and pull in paid Bupa invoices without matching them by hand. Claims management is included in every Pabau subscription.

Manage private cardiology billing from one place

Pabau helps UK private practices attach cath lab documentation, track prior authorisation status, and submit clean CCSD claims to Bupa, AXA Health, and Aviva.

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Conclusion

Choosing K4910 comes down to two facts in the cath lab report. A stent was left in place, and the catheter went in through the femoral or brachial artery. Get either wrong and the claim fails, however good the clinical work was.

Most of the money on a stent claim is lost at the booking stage. Confirm the authorisation, the insurer’s stance on stent costs, and its multivessel rule while the case is still being booked. Each one takes minutes then and weeks once a query arrives.

Book a demo to see how Pabau keeps authorisation, cath lab documents and CCSD claims together for private cardiology practices.

Continue your research

Looking up a neighbouring code? CCSD codes gathers our CCSD procedure code guides in one library, so you can check descriptors before you submit.

Preparing the authorisation request? Medical prior authorization form gives you a ready-to-fill form covering patient and plan details, the requested procedure with its codes, and the clinical justification.

Frequently asked questions about CCSD Code K4910