# Coronary Stent Codes



## smiller (May 15, 2013)

Hi everybody - Please check my coding - Here's the report ....


PROCEDURE:
1.  Coronary arteriography.
2.  Percutaneous transluminal coronary angioplasty and stent
    implantation of the proximal segment of the left anterior
    descending with a drug-eluting stent.
3.  Percutaneous transluminal coronary angioplasty and stent
    implantation of the first obtuse marginal branch of the left
    circumflex system with a drug-eluting stent.
4.  Percutaneous transluminal coronary angioplasty and stent
    implantation of the distal segment of the right coronary
    artery with a drug-eluting stent.

CORONARY ARTERIOGRAPHY:  The left main coronary artery was
normal.  The left anterior descending coronary artery was totally
occluded proximally.  The left circumflex system, the first
obtuse marginal branch contained a proximal 95 percent narrowing.
The right coronary artery was a dominant vessel.  The distal
segment before the crux contained a discrete 95 percent narrowing.

LEFT ANTERIOR DESCENDING INTERVENTION:  We started with an 8-
French FL4 short-tip guiding catheter, a 0.014 Pilot-50
guidewire.  We were able to cross the totally occluded left
anterior descending segment.  We predilated with a 2 mm balloon
and then stented this region with a 3.0 x 26 mm length resolute
stent to a normal appearance.  We then turned our attention to
the first obtuse marginal branch and stented this region with a 3.
0 x 18 mm length Resolute stent to a 25 percent narrowing.  We
stented the distal right coronary artery with a 2.5 x 18 mm
length Resolute stent to a normal appearance.

CONCLUSION:
1.  Total occlusion of the left anterior descending coronary
    artery.
2.  Hemodynamically significant stenosis of the left circumflex
    system.
3.  Total occlusion of the right coronary artery.
4.  Successful percutaneous transluminal coronary angioplasty and




                     CARDIAC CATHETERIZATION
                           Page 1 of 2

    stent implantation of the proximal segment of the left

    anterior descending with a drug-eluting stent.
5.  Successful percutaneous transluminal coronary angioplasty and
    stent implantation of the proximal segment of the first
    obtuse marginal branch of the left circumflex system with
    drug-eluting stent.
6.  Successful percutaneous transluminal coronary angioplasty and
    stent implantation of the distal segment of the right
    coronary artery with a drug-eluting stent.

 Here's what I get:  92928-LD
                             92928-51-LC
                             92928-51-RC
                             93454-26-59 

Thank you.


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## TWinsor (May 16, 2013)

wondering if 92943 can be used for the LAD since "total occlusion" or does the documentation need to state specifically "Chronic total occlusion"?


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## smiller (May 16, 2013)

Hello - thank you - that's a good point - I think "total occlusion" is good enough, as far as I know.  So possibly should be coded as 92928-LC, 92943-LD, 92944-RC, 93454-26-59.  What do you think?


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## TWinsor (May 20, 2013)

I would not use 92944 for the RCA.  In the body of the report it reads 95% narrowing which is not a "total occulsion".  I would code;

92943-LD
92928-LC
92928-59-RC
93454-26-59 (assuming the patient did not have a prior diagnostic heart cath)

HTH!


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## smiller (May 20, 2013)

Ok - thank you for your help, Terri


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