Cardiology Coding Alert

Question: Should I use a modifier for 92981? We are getting denials as incidental to the primary procedure. Code 92981 is an add-on. I reported it twice in addition to the primary procedure.
Virginia Subscriber

Answer: You need to report the vessel-based code (92980, Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) in order to report the add-on code you mention (+92981, Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; each additional vessel [list separately in addition to code for primary procedure]).

Because the Correct Coding Initiative (CCI) bundles each of the coronary intervention codes into each other (including the base vessel and the "each additional" vessel codes), you need to use the appropriate anatomic modifiers. This means you should append vessel modifiers (LC, Left circumflex coronary artery; RC, Right coronary artery; or LD, Left anterior descending coronary artery) after the procedure code to demonstrate to the carrier where the cardiologist performed the intervention.

For example, reporting 92980-RC and 92981-LC clearly shows carriers that your cardiologist performed these procedures in different vessels.

Remember: The cardiologist must perform interventions in two of the officially recognized vessels for you to code two procedures. If all three were done in the same vessel, you should use only one code (92980).

-- You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC-CARDIO, CHCC president of CardiologyCoder.Com, Inc. andcompliance manager for several cardiology groups around the country.