Cardiology Coding Alert

Hint:  Avoid coding more than once for a vessel's sub-branches

Absorb all the intracoronary stent coding advice from "3 Steps to Perfect Intracoronary Stent Placement Coding" on page 81? See how you fared coding these four scenarios.

Answer 1: You'd report 92980-RC (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel; right coronary, or RCA) and the "each additional vessel" code, +92981-LD (... each additional vessel [list separately in addition to code for primary procedure]; left anterior descending). This scenario took place in two different vessels--the right coronary and the left descending--so you'd report the two codes. You should not use modifier 51 (Multiple procedures).

Answer 2: You should only use 92980. You won't be reimbursed for any additional codes for the angioplasty of the LAD sub-branches because they are all part of the same major coronary artery.

Answer 3: You would report 92980-LD to describe the stenting, single vessel, of the LAD and 92981-RC to describe the stenting, additional vessel, of the RCA. You shouldn't include a separate code for the RCA angioplasty because most payers will consider this part of the stenting procedure the cardiologist eventually performed on that artery.

Answer 4: Did you include a code for the atherectomy in the LAD? You shouldn't have. You should only report 92980-LD and 92984-LC. The atherectomy of the LAD is a lesser procedure than the stenting one, so you shouldn't include it on your claim.