Cardiology Coding Alert

Question: I have a physician who did a left heart catheterization, fractional flow reserve (FFR), percutaneous transluminal coronary angioplasty (PTCA) of left anterior descending artery (LAD), no stent, then stent of ramus intermedius (RI), stent of left circumflex (LC), and a stent in the posterior descending. Can you please help me code the procedure?

AAPC Forum Subscriber

Answer: You should code by what vessel was stented, not by how many stents were placed. There are five recognized major coronary arteries: the left main, left anterior descending, left circumflex, right, and the ramus intermedius. So, you should report the following on your claim:

• 93458 (Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed)-59 (Distinct procedural service)
• 92920 (Percutaneous transluminal coronary angioplasty; single major coronary artery or branch)-LD
• 92928 (Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch)-RI
• 92928-LC
• 92928-RC

Caution: If you are coding for the hospital and drug-eluting stents were placed, change 92928 to C9600 (Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch).