# 92928 and 92929 HELP



## staticsis2 (Dec 18, 2013)

Is anyone having trouble being paid for PTCA/Stent code 92929  when using it with 92929 and you have two separate arteries?  I don't understand why it was published that we could use this as an add on code and yet all my carriers are rejecting the 92929 when I have documentation to support the additional artery being stented.

Thank you in advance for your help.


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## theresa.dix@tennova.com (Dec 18, 2013)

staticsis2 said:


> Is anyone having trouble being paid for PTCA/Stent code 92929  when using it with 92929 and you have two separate arteries?  I don't understand why it was published that we could use this as an add on code and yet all my carriers are rejecting the 92929 when I have documentation to support the additional artery being stented.
> 
> Thank you in advance for your help.



Ok let me tell you right now that 92929 has no RVU s associated with it on the fee schedule. So when you use 92929 you will not get any reimbursement? Did you know that?
If you have two separate main vessels use 92928 twice.


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## staticsis2 (Dec 18, 2013)

Yes however it was my understanding that it is an add on code and we should report it because it is a new code and until enough are reported by physicians then they will recv RVU'S? So if you are using say 92929 for Rc, then I can use 92928 for LC as well? What would I do append a modifier 59 to the 2nd vessel and it won't be denied?


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## Jess1125 (Dec 18, 2013)

staticsis2 said:


> Yes however it was my understanding that it is an add on code and we should report it because it is a new code and until enough are reported by physicians then they will recv RVU'S? So if you are using say 92929 for Rc, then I can use 92928 for LC as well? What would I do append a modifier 59 to the 2nd vessel and it won't be denied?



Yes, I agree. If your doctor did the work of one of the new add on codes for PCI, yes, do report it anyway. 

If your doctor is placing a stent in the RC and the LC, yes, you do use 92928 twice with the appropriate vessel modifier attached to each one. (92928-LC and 92928-RC). 

The add on codes are reserved for when the doctor for example stents an artery and also places a stent in the BRANCH of that same artery. For example, stent was placed in the LAD and also in a diagonal branch. Then this scenario would be 92928.LD and 92929.LD. 

The "base" codes can be reported for each major artery. LC, LM, LD, RI, RC. Most of the time they should be paid. Can't promise all the time. I have a select couple that say that 92928 can only be paid once that I do have to fight on.

Jessica CPC, CCC


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## staticsis2 (Dec 19, 2013)

Jessica, thank you for your help in getting me to understand this.  Just to be clear if he does a 92928 RC and a 92928 LC I append and 59 to the second one, if denied appeal it correct? Then if he does a 92928 in the LC 2x different branch still report the 92928 LC and 92929 LC so reporting shows the additional ?
Thanks


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## Jess1125 (Dec 19, 2013)

staticsis2 said:


> Jessica, thank you for your help in getting me to understand this.  Just to be clear if he does a 92928 RC and a 92928 LC I append and 59 to the second one, if denied appeal it correct? Then if he does a 92928 in the LC 2x different branch still report the 92928 LC and 92929 LC so reporting shows the additional ?
> Thanks



Yes, you are correct and understand. I don't know what everyone else does. We do not apply the -59 modifier to the second and subsequent stents and don't seem to have an issue but I'm sure some offices may put it on. To me, the vessel modifiers should be enough to tell the insurance company why it is being reported again. 

Jessica CPC, CCC


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## staticsis2 (Dec 20, 2013)

Thanks Jessica for your help again, I truly appreciate it.


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## vanessa.bonaventura@yahoo.com (Jan 21, 2020)

Hello,
Seeing as this forum is dated December of 2013. I am wondering if these guidelines are still correct today?  
I have a denial for 92929 being bundled into 92928,LC. The medical record suggests two stents were placed in an "over-lapping fashion" on LC. 
In this case we could only expect payment for one 92928 seeing as both stents placed on the same artery? Right?

I'm new to AAPC and the coding world (currently studying for CPC). Any feedback would be much appreciated 

Thank you


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## Jim Pawloski (Jan 21, 2020)

Overlapping stent placement is one stent charge code.

HTH,
Jim Pawloski, CIRCC


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## wildkingdom (Feb 13, 2020)

Hello,

When reporting 92928-RC and 92928-LC I have always coded the second one (the LC) as 92928-76,LC.  You are coding the same procedure with the same physician, thus the 76 modifier distinguishes that.  I have never used a 59 on those because I don't think it's appropriate.  I have had denials when the 76 modifier was not used.  I hope this furthers your awareness of coding that scenario!


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