Cardiology Coding Alert

Question: One of our physicians stented a patient's proximal left anterior descending coronary artery (LD) but had to go back in later and insert a second stent to the LD. When I entered the charges for the second stent, I was told to use modifier -25 but now am not sure if I did the correct thing. Should I have charged the second stent using modifier -76 instead and sent the notes?

Virginia Subscriber

Answer: The assumption here is that the patient left the cardiac catheterization lab but had chest pains and had to return to the lab for a dissection of the previously placed stent on the same day.

You should appended modifier -76 (Repeat procedure by same physician) when reporting the second stent instead of modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). Use modifier -25 for evaluation and management codes only. The stent code (92980) is a procedure code, so you would only append a procedural modifier, such as modifier -76.