Part B Insider (Multispecialty) Coding Alert

Question: My cardiologist attempted a PTCA but determined after several attempts that it was impossible, so he terminated the procedure. Can I still bill it as code 92982?

Answer: You may report the appropriate percutaneous transluminal coronary angioplasty (PTCA) code, such as 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel). But you should append modifier 52 (Reduced services) when the physician chooses to terminate the procedure.

On the other hand: If the cardiologist had crossed the lesion and inflated the balloon, but documented that the outcome of the angioplasty was unacceptable, you should not append modifier 52.

Or if the cardiologist aborts a diagnostic heart cath after initial catheterization of the femoral artery because the patient's blood pressure could not be stabilized, then you would append modifier 53 (Discontinued procedure) instead of 52 on the intended procedure. You would use modifier 53 because CPT Appendix A indicates that modifier 53 is appropriate when the physician discontinues a procedure due to circumstances "that threaten the well being of the patient."

The procedure: In PTCA, the cardiologist threads a specialized guidewire through the blockage and passes a deflated balloon over the wire. She inflates the balloon once it's in position, and creates a passageway by pushing the pliable blockage against the artery's sides.