Cardiology Coding Alert

Question: How should I report stents in the LAD, OM1, and OM2?

Codify Subscriber

Answer: From a CPT® perspective, proper coding would be:

• 92928-LD, Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch; Left anterior descending coronary artery
• 92928-LC, … Left circumflex coronary artery
• +92929-LC, Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; each additional branch of a major coronary artery (List separately in addition to code for primary procedure).

Rationale: Code 92928-LD represents the stent placement in the left anterior descending (LAD) artery. OM1 and OM2 are the obtuse marginal branches of the left circumflex artery, so modifier LC is used to identify them. Use 92928-LC to represent the first branch and +92929-LC to represent the additional branch.

Snag: Don’t expect separate payment from Medicare for +92929-LC. Medicare gives this code status B, meaning payment for the code is bundled into other services performed on the same date (in this case, 92928).