# Failed stent placement



## brittany1356 (Feb 4, 2013)

Hello fellow coders 

I have a question. If an interventionalist attempts a stent placement and advances the stent into the artery but is unable to get the stent to the culprit area, but does perform an angioplasty. Would you bill for a stent placement with a 53 modifier, or only bill for the angioplasty? 

Thank you, 
Brittany L, CPC


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## theresa.dix@tennova.com (Feb 5, 2013)

brittany1356 said:


> Hello fellow coders
> 
> I have a question. If an interventionalist attempts a stent placement and advances the stent into the artery but is unable to get the stent to the culprit area, but does perform an angioplasty. Would you bill for a stent placement with a 53 modifier, or only bill for the angioplasty?
> 
> ...



Hi Brittany,
 I would bill for the angioplasty.


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## CPCCODERII (Feb 5, 2013)

I would bill for the stent placement with the modifier.  The doctor attempted to place the stent, the supplies were used so it is appropriate to bill the stent code.  I found this on the Zhealth publishing website and this is what we have always referred to.

"When a procedure is discontinued, the first consideration should be if there was a lesser procedure that was performed.  If a lesser procedure was all that was performed, the lesser procedure is reported instead of a discontinued procedure.  For example, if the patient presents for stent placement in the right coronary artery and an initial PTCA causes the patient to go into fibrillation, resulting in discontinuing the procedure, the PTCA would be reported, not a discontinued coronary stent placement.  However, if a stent had been prepared for insertion and had to be discarded because of discontinuing the procedure after the PTCA, the discontinued stent placement would be reported and not the PTCA.  Reporting is somewhat dependent on the resources utilized.  The example given may result in the hospital reporting a discontinued coronary stent placement because the hospital has the cost of the stent and the physician reporting a completed PTCA, since the physician is reporting the actual work the physician performed.  There was no attempt to place the stent, so the physician has not performed any of the work of a stent placement.  Modifiers for discontinued procedures are to compensate the provider for the resources utilized, so how far the procedure progressed, the time spent attempting to complete a procedure, and the supplies utilized or discarded play a role in how the procedure is reported.

Supporting documentation should:
•be available upon request by the payer,
•state the procedure was started,
•why the procedure was discontinued, and
•state the percentage of the procedure that was performed.
For physician billing the report will need to be submitted and notes indicated on the 1500 claim form as to why the discontinued procedure was reported."


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## brittany1356 (Feb 6, 2013)

Thank you!


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