# 2 stents in same vessel in same day; different times?



## charityelaine (Feb 24, 2010)

Ok, here's the scenario I need help with:
Physician did a LHC and stented the RC due to MI w/ post-infarct angina.

"A few hours later, the patient had recurrence of severe pain of the similar nature so he was advised to undergo repeat imaging to rule out stent thrombosis."
".....Proximal to the stent, there was tubular stenosis which was about 60%, appeared to be slightly worse w/ possible spasm & imaging of uptake......"
Decision was made to place a bare metal stent proximally to the RC stent previously placed.

My question is...can we bill for the second stent placement since the patient had to come back to the cath lab at a different time in the same day or would it be considered "complimentary" (if you will)? I know that Medicare states only one stent per vessel can be charged for (92980).
PLEASE HELP!!! Thanks. 

Charity


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## mitchellde (Feb 24, 2010)

I hear what you are saying and I think I would try the 76 modifier on this since there was a return tot he OR.


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## dlynes (Feb 25, 2010)

Yes you may bill for the additional stent with a 76 (same Physician).  You may also bill for the diagnostic cath if done because of new signs and symptoms.  Use the diagnosis of the new signs and symptoms for the diagnostic and CAD for the stent.


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