# PCI and PTCA Same Day



## cargo (Nov 2, 2011)

Patient had cardiac cath followed by PCI & thrombectomy of LC. 

92980/LC 
92973 
93548/26/59 

Later that day, severe chest pain and EKG changes occurred & patient went back to cath lab for acute stent thrombosis. Doc performed coronary angiography that demonstrated thrombotic occlusion within the stented segment. He performed mechanical thrombectomy, PTCA & IVUS of the stented segment. 

I'm looking for input on coding the 2nd procedure. I can't modify the 92982 for the PTCA even though it's a separate session, so he just loses that? And would/should I bill the coronary angiography - 93454/26/59 since new symptoms developed? Otherwise, I'm just left with the IVUS and 2nd thrombectomy maybe with a 78? 

TIA, 
Carol Wright, CPC


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## Jess1125 (Nov 2, 2011)

cargo said:


> Patient had cardiac cath followed by PCI & thrombectomy of LC.
> 
> 92980/LC
> 92973
> ...



Yes, you can bill for everything that was done in the 2nd procedure. You can bill for a PTCA as this was a different session. Yes, bill the 93454.26.59 as the patient's condition had changed since his last study. Bill for IVUS.

I'd be careful about the thrombectomy, though. I don't know what kind of thrombectomy was done but if it was an aspiration thrombectomy this will be included in the intervention. The 92973 is intended for a mechanical thrombectomy. (Only catheter approved for this code would be an Angiojet I believe)

Jessica CPC, CCC


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