Cardiology Coding Alert

Question: Which CPT codes describe left anterior descending artery PTCA with stent insertion and right coronary artery PTCA with atherectomy?

Maryland Subscriber

Answer: You should report the following:

• 92980-LD -- Transcatheter placement of an intracoronary stent(s), percutaneous, with or without other therapeutic intervention, any method; single vessel; Left anterior descending coronary artery

• +92996-RC -- Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure); Right coronary artery.

92980: Reporting 92980-LD covers both the left anterior descending percutaneous transluminal coronary angioplasty (PTCA) and stent placement. Reason: Coding guidelines indicate you should include the PTCA in the stent code. Specifically, CPT states that "coronary angioplasty [92982, +92984, Percutaneous transluminal coronary balloon angioplasty ...] or atherectomy [92995, +92996, Percutaneous transluminal coronary atherectomy ...], in the same artery, is considered part of the stenting procedure [92980] and is not reported separately."

+92996: For the right coronary PTCA with atherectomy, you should use "additional vessel" code +92996- RC rather than a "single vessel" code such as 92995 (Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; single vessel).

Support: CPT guidelines under stent codes 92980-+92981 state, "To report additional vessels treated by angioplasty or atherectomy only during the same session, see 92984, 92996." In addition, CPT Assistant (December 1996) addresses the subject in describing how to code stent placement in one vessel (92980) and angioplasty in another (+92984, Percutaneous transluminal coronary balloon angioplasty; each additional vessel [List separately in addition to code for primary procedure]), indicating that the "additional vessel" code is appropriate in these situations. The article states the "information applies similarly to atherectomy procedures."