Cardiology Coding Alert

Discover how the number of coronary artery repairs affects your claim

Fed up trying to understand what 92980-92981 include, how to report multiple stents in different vessels, and what to do when your cardiologist performs other interventions as well? Let our experts answer your questions. Step 1: Know What CPT 92980 and CPT 92981 Include The first step to avoiding coding inaccuracy is to know what's contained in the intracoronary stent placement codes 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) and +92981 (... each additional vessel [list separately in addition to code for primary procedure]). A previously scheduled (AKA elective) stenting procedure includes the following components:

• the normal preoperative assessment and sedation,

• obtaining vascular access,

• placing various guidewires and catheters for use during the procedure,

• angiography necessary to guide the procedure,

• predilatation of the lesion (such as angioplasty),

• placement of the stent(s) in the targeted coronary vessel

• angiography to confirm the procedure's success, and

• withdrawal of all equipment, obtaining hemostasis and the normal postoperative course. Diagnostic Cardiac Caths Not Included These codes do not include the diagnostic cardiac catheterization that prompted the cardiologist to decide an intervention was necessary. With urgent interventions, however, you may be able to receive reimbursement for the diagnostic procedure, depending on your circumstances.

For example, if angiography is part of a planned intervention, you would not report it (the catheter placement or the radiological supervision and interpretation). But if a cardiologist does the left heart catheterization and determines the patient needs an urgent intervention (which is often the case), you can report both and be paid for both, says Melissa Bedford, a coding specialist at Austin Heart PA in Texas.

When a diagnostic heart catheterization (93510-26, 93543, 93545, 93555-26 and 93556-26) reveals the need to proceed to the intervention, you can report it and get paid for both the diagnostic heart catheterization and the stent.
 
Just make sure to attach modifier 59 (Distinct procedural service) to the supervision and interpretation codes (93555, Imaging supervision, interpretation and report for injection procedure[s] during cardiac catheterization; ventricular and/or atrial angiography; and 93556, ... pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]), says Heather Stecker, CPC, senior coding and financial analyst at the Cardiology Consultants of Philadelphia PC.
 
Appending this modifier will illustrate that these are not the angiographic services which the National Correct Coding Initiative (NCCI) includes in the stent placement service.

Example: If your cardiologist performs a left heart catheterization (93510, Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous), left ventriculogram (93543 and 93555-26) and coronary angiography (93545 and 93556-26) for diagnostic [...]