Cardiology Coding Alert

Question: The patient arrived through the ED with an acute myocardial infarction (AMI) and was taken emergently to the catheterization lab. After the patient was appropriately prepped and anesthetized, my cardiologist made an incision in the brachial artery and inserted a guidewire through it. They then inserted a guide catheter over the guidewire, moving it through the vascular system until they could position the catheter at the opening of the coronary artery. My cardiologist injected a dye and took fluoroscopic images to examine the patient’s blood flow and placement of the catheter into the artery. They introduced a special catheter that removed blood clots from the vessel. My cardiologist also advanced a catheter with a burr into the coronary vessel to destroy the material blocking the artery. During the same session, my cardiologist inserted a balloon-tipped catheter into the coronary lesion and inflated the balloon to flatten the plaque against the artery wall. My cardiologist further inserts a balloon-mounted catheter with a stent into the stenosed site. The balloon expanded and fit the stent on the wall of the artery. Lastly, they removed all the equipment, achieved hemostasis, and closed the wound in layers. How should I report this procedure?

California Subscriber

Answer: You should report 92941 (Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel) for this procedure.

Code 92941 includes aspiration thrombectomy when performed, so an aspiration thrombectomy is not required for this procedure. But you should not report aspiration thrombectomy separately when your provider performs it.