# Coding PCI's in 2013?



## amym (Feb 14, 2013)

Is it appropriate to code this as 92928-LD, 92921-RC and 93571-26?

SUMMARY: 

--  1ST LESION INTERVENTIONS: 
--  A drug-eluting stent was performed on the 75 % lesion in the proximal 
LAD. 

--  2ND LESION INTERVENTIONS: 
--  A percutaneous intervention was performed on the 60 % lesion in the 
proximal RCA. 

PROCEDURES PERFORMED: 

--  Coronary Drug Eluding Stent Placement. 
--  Interventional Flow Wire. 
--  Coronary Stent Placement. 
--  Intervention on proximal LAD: . 
--  Intervention on proximal RCA: percutaneous intervention. 

INDICATIONS: Congestive heart failure with ischemic cardiomyopathy. 

PROCEDURE: The risks and alternatives of the procedures and conscious 
sedation were explained to the patient and informed consent was obtained. 
The patient was brought to the cath lab and placed on the table. The 
planned puncture sites were prepped and draped in the usual sterile 
fashion. 

LESION #1 INTERVENTION: A drug-eluting stent was performed on the 75 % 
lesion in the proximal LAD. 

--  A PE Plus MR 2.75 x 16 drug-eluting stent was placed across the lesion 
and deployed at a maximum inflation pressure of 28 atm. During the 
procedure, the previous guider was changed for a Runway 6FR LBU 3.5 
guider, and a new BMW HT 190cm wire was advanced across the lesion. 

--  Balloon angioplasty was performed, using a NC Sprinter 3.25 x 6 
balloon, with 1 inflations and a maximum inflation pressure of 18 atm. 

LESION #2 INTERVENTION: A percutaneous intervention was performed on the 
60 % lesion in the proximal RCA. There was no dissection. 

--  Myocardial Fractional Flow Reserve (FFR) measurement was performed 
using a 0.014" pressure-monitoring 175cm Certus Pressure guide-wire. 
Steady baseline values were obtained. Mean arterial pressure and mean 
distal coronary pressures were then obtained at maximum hyperemia. 

CARDIAC INTERVENTIONS 
--  Coronary Drug Eluding Stent Placement. 

--  Interventional Flow Wire. 

--  Coronary Stent Placement. 

COMPLICATIONS: 
Arrhythmia Requiring Intervention occurred during the cath lab visit. 
PROCEDURE COMPLETION: The patient tolerated the procedure well. TIMING: 
Test started at 08:33. Test concluded at 10:06. RADIATION EXPOSURE: 
Fluoroscopy time: 13.36 min. 
MEDICATIONS GIVEN: 
Adenosine (Adenocard), 90 mcg, intracoronary, at 09:47. 
Adenosine (Adenocard), 120 mcg, intracoronary, at 09:50. 
Heparin, 8000 units, IV, last dose at 09:15. 
Prasugrel, 60 mg, PO, at 10:05. 


STUDY DIAGRAM 

Angiographic findings 
Native coronary lesions: 
7Proximal LAD: Lesion 1: 75 % stenosis. 
7Proximal RCA: Lesion 1: 60 % stenosis. 
Intervention results 
Native coronary lesions: 
7of the 75 % stenosis in proximal LAD. Stent: PE Plus MR 2.75 x 16 
drug-eluting. 
7percutaneous intervention of the 60 % stenosis in proximal RCA.


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## dpeoples (Feb 14, 2013)

amym said:


> Is it appropriate to code this as 92928-LD, 92921-RC and 93571-26?
> 
> SUMMARY:
> 
> ...



I think I would code this:
92928 LD
92920 RC (separate primary artery, not a branch of LD to warrant 92921)
93571026

HTH


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