Cardiology Coding Alert

Question: Our hospital has revised its catheterization lab coding sheet to include the left main coronary artery for angioplasty, stent placement and atherectomy. Has a new modifier been established for the left main coronary artery for use with interventional coronary procedures?

Texas Subscriber  
Answer: There is no modifier or code that is used nationwide to indicate an intervention in the left main artery, which feeds both the left anterior descending artery and left circumflex.
 
Some local carriers (both Medicare and private) include modifiers for left main procedures. It is possible for a local carrier to establish such a modifier; if this is the case, the carrier should be identified and the modifier used only for claims submitted to that payer.
 
Note: The American College of Cardiology says that if an intervention is performed in the left main artery and a second intervention is performed in either the left anterior descending artery or left circumflex, only the highest-valued procedure should be reported.