# 92980 and 93454



## brandyleigh23 (Mar 18, 2011)

When my docs performs a stent with PCI how do I know to code for a selective coronary angiogram?  I have one doc in particular that ALWAYS states he performed a selective coronary angiogram. He talks about the coronary artery being engaged and Angiomax started but then he goes straight into the ballooning for angioplasty... HELP!

Brandy Edmondson, CPC


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## dpeoples (Mar 18, 2011)

brandyleigh23@hotmail.com said:


> When my docs performs a stent with PCI how do I know to code for a selective coronary angiogram?  I have one doc in particular that ALWAYS states he performed a selective coronary angiogram. He talks about the coronary artery being engaged and Angiomax started but then he goes straight into the ballooning for angioplasty... HELP!
> 
> Brandy Edmondson, CPC



Here are some questions that should be answered before you code a coronary angiogram:

1. Was the coronary angiography (the one he ALWAYS does) _*diagnostic*_? (no previous angiography, insufficient previous angiography or change in patient condition). 
2. If the coronary angiography was/is _*diagnostic*_, is there a separate dedicated report for this portion of the procedure?

Answering these two questions will help determine whether a heart cath with coronary angiography should be billed in addition to the intervention.

In many cases, the condition being treated has already been diagnosed by a previous heart cath/coronary angiography, and should not be billed again when the injections are being performed primarily for guidance purposes in facilitating the interventional procedure.

HTH


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## brandyleigh23 (Mar 21, 2011)

Thank you for your response. I understand exactly what you are saying. I believe he is not performing the angiography selectively but only as guidance to the intervention. It is revealing more stenosis or improvement of the lesion as he dilates the balloon and places the stent. Thank you again!

Brandy Edmondson, CPC


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