# Attempted Pci



## willnat2 (May 23, 2011)

I could really use some help. I have just started coding caths, stents, pacers, etc.. The lady that was doing it quit and I only had 3 weeks to learn.

Mr. M has coronary artery disease by coronary bypass graft surgery as well as recent PCI. He was found to have a totally occluded left circumflex and was referred for elective attempt at PCI of the occluded circumflex.
Procedures Performed: Attempted PCI of left circumflex occlusion.
Complications: None
Procedure in Detail: After obtaining informed consent, the patient was transferred to the cardiac cath lab in stable condition. The patient draped and prepped in a sterile fashion. The right groin was anesthetized locally using 1% lidocaine. The right femoral artery was cannulated using the modified Seldinger technique, and a 6-French arterial sheath was introduced. An XB 3.5 guide catheter was advanced into the left main without difficulty. Angiography confirmed a totally occluded mid left circumflex with a very small channel that appeared to be manageable with a wire. Of note is that there was a segment of aneurysm just proximal to the occlusion. A Pilot 50 guidewire was used to cross the lesion which did initally cross the first severe lesion. Howerer, it resulted in entering the aneurysmal segment and not the potential channel. In light of favoring the aneurysm, a decision was made not to proceed with more aggressive angioplasty as this channel had been formed and was favoring wire passage.
Impression: Attempted percutaneous coronary intervention of totally occluded left circumflex with inability to cross the wire into the true channel to the distal artery. 

I know she said that you could code what was done. Would that be 93455,26? Or would I code 92982 LC 53 mod. I sure would appreciate any help. I know I will have more questions in the future. Thanks in advance!


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## dadhich.girish (May 23, 2011)

I have not had much hands on coronary cases, but as far as my understanding goes, I would go ahead with 92982-53/LC.

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## theresa.dix@tennova.com (May 25, 2011)

dadhich.girish said:


> I have not had much hands on coronary cases, but as far as my understanding goes, I would go ahead with 92982-53/LC.
> 
> -



92982 52-LC
Modifier 52 if procedure was stopped and patient was stable 53 if procedure was stopped because patient became unstable


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## willnat2 (May 28, 2011)

Girish and Theresa,

Thank you both so much for your help. I really appreciate it. Reading all of the other posts have helped me also. I am so nervous, starting this new job. The doctors have given me this chance and I hope I can do well. I just got my review book to study for the test. I hope to take it by fall. There is just so much new to learn. 
Thanks again,

Leslie


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