# coding 92941 twice?



## mabar1571 (Jan 15, 2013)

This is giving me fits.  Every seminar or crosswalk I have says to bill 92941 for every vessel treated in a acute MI case.  The problem I have is that in the cpt book it clearly states that "for additional vessels treated, see 92920-92938 and 92943-92944".  

So it is saying -for additional vessels treated (and they don't spell out they mean only branches or all other major arteries and branches) use any code but 92941 again.  

Does anyone have any credible info as to what this means in coding interventions in acute MI cases?  

My thought was that it means if any major cor.artery or it's branch was occluded (and the documentation shows this) than you can code using the 92941, but if-for example- the LAD was documented as 70% occluded and there was also a 40% stenosis in the LC-with no occlusion noted-then you would code 92941-LAD and then code the intervention done to the LC-say they stented you'd use 92928.  

Occluded means blocked and stenosis means narrowing and doesn't necessarily mean blockage.   Am I wrong in this understanding?


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## theresa.dix@tennova.com (Jan 17, 2013)

mabar1571 said:


> This is giving me fits.  Every seminar or crosswalk I have says to bill 92941 for every vessel treated in a acute MI case.  The problem I have is that in the cpt book it clearly states that "for additional vessels treated, see 92920-92938 and 92943-92944".
> 
> So it is saying -for additional vessels treated (and they don't spell out they mean only branches or all other major arteries and branches) use any code but 92941 again.
> 
> ...



I have Jim Collins information from a webinar. He has written Report 92941 for each vessel, any intervention PTA,PTE or Stent. So to me that is saying use it twice if its documented AMI stenting. I looked in CPT and I think that is misleading. But I took that as for addtional vessels that are not AMI use these codes. 

That is how I am going to code it.


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## j.monday7814 (Jan 21, 2013)

usually but not always, the acute MI is caused by one major vessel and 92941 would be appropriate. any other occlusions beyond that would be treated as a separate intervention. My physicians usually state something like this, "patient presents with an acute anterior wall myocardial infarction, the culprit vessel appears to be the left anterior descending"


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## theresa.dix@tennova.com (Jan 23, 2013)

jeremym@pimaheart.com said:


> usually but not always, the acute MI is caused by one major vessel and 92941 would be appropriate. any other occlusions beyond that would be treated as a separate intervention. My physicians usually state something like this, "patient presents with an acute anterior wall myocardial infarction, the culprit vessel appears to be the left anterior descending"



 Jeremy,
 Yes I have been trying to find out more about how to use 92941 and you said it just the way it is. Usually only one vessel is involved in the AMI. Thank you.


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## mabar1571 (Jan 31, 2013)

that is my thinking as well--that usually only one major vessel is involved and you would use 92941 for that, and if another branch of that major vessel or another major vessel had an intervention done you would use the other appropriate code (other than the 92941).  Though, I did have an acute MI that involved both the RC and the LD and in that case I have no problem coding 92941 twice--because dr.documented that both were involved.


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