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Cardiology Coding Alert

READER QUESTIONS:

Keep 93508 for Diagnostic Cath

Published on Sat Jan 03, 2009

Question: If I'm reporting 92980 and 92981's professional component, may I report 93508, too?

California Subscriber

Answer: If you use 93508 (Catheter placement in coronary artery[s], arterial coronary conduit[s], and/or venous coronary bypass graft[s] for coronary angiography without concomitant left heart catheterization) to represent a diagnostic procedure, you should be able to report it alongside 92980 and +92981 (Transcatheter placement of an intracoronary stent[s] ...). But as AMA's CPT Assistant (August 2000) states, you should not use 93508 to report the necessary catheter insertion for a percutaneous intracoronary stent procedure.

Reason: AMA's CPT: 2009, Professional Edition, explains that 93508 describes a cardiac catheterization in which the cath doesn't cross the aortic valve into the left ventricle. CPT didn't intend 93508 to describe roadmapping.

Snag: Correct Coding Initiative (CCI) edits don't bundle 93508 into 92980, but you may need to append modifier 59 (Distinct procedural service) to 93508 for some payers. You may have to appeal, explaining that 93508 represents a diagnostic procedure separate from the stent placement. But coders report that certain payers won't cover 93508 on the same day as 92980 even after appeal.

--You Be the Coder and Reader Questions prepared with the assistance of Jim Collins, CCC, CPC, ACS-CA, CHCC, president of www.CardiologyCoder.Com.

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