Cardiology Coding Alert

Question: We have been informed that we can get reimbursed for multiple stents in the same vessel but have tried several approaches without success. We use 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) with modifier -22 (Unusual procedural services) and send it as a hard copy with a letter and op notes. Is this correct, or is there a better way?

Colorado Subscriber


Answer: 92980-22 is correct. The best way to obtain additional reimbursement with modifier -22 is to educate the payer regarding why you are requesting additional reimbursement. A cover letter outlining the complex nature of the case, as well as a comparison with a "normal" procedure note, is very helpful. Explain the difference between the "average" stent placement and the complex case, and explain why it was difficult and required more effort and skill by the physician.