# Stent in ramus and lad



## mshelly87 (Jun 2, 2010)

What is the correct way to code a stent placement in the ramus intermedius and the LAD? Thanks in advance.


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## sbicknell (Jun 2, 2010)

The Ramus is a branch off the Left Main and lies between the LAD and LCX and not everyone has a Ramus. Instead of the Left Main splitting into 2 vessels (LD And LC) it splits into 3 vessles (LD, LC and Ramus). But the Ramus is considered a branch (and not a vessel)of the either the LD or the LC so the branch rules apply

So basically you are placing a stent on 1 vessel and another stent on a branch of a 2nd vessel with both coming off of the Left Main. Medicare has been pretty clear that they will only consider interventions on the 3 vessles identified by CPT, the LD, LC and RC. 

So for codng, the Ramus can be coded as either a branch of the LD or the LC. So suggest coding 
92980-LD   (your LAD vessel)
92981-LC   (the ramus branch of the LC)


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## mshelly87 (Jun 3, 2010)

Thanks for responding, that is how I have been coding it but for some reason I was second guessing myself this time. I also have another question I was wondering if you would be willing to tackle. When aortography is done in conjuction with stend and cath and  stent an report states aortography confirms only 2 patent grafts. No dissecction anuerysm how should this be coded? I have been using the 93544 unless they comment on renals or something. Is this correct?


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## gsfredrickson@gmail.com (Jan 7, 2013)

92980 & 92980 deleted codes in CPT 2013. To report see 92920-92944


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