Wiki Angiplasty

[Ravikirann]

Dear All,
I come across doubt with the below ot notes from my hospital. Doctor has used balloon and stent for two vessels. Should i code normal angioplasty 92980 and 92981 or balloon angioplasty in this case. kindly help me out.


Indication : Unstable angina. Catheters : lL3.5 and lR3.5-6F.
Contrast : Omnipaque 350 mg/ml, total 350ml.

Access : Right femoral artery. Medication : NS, Heparin and NTG. LM : Normal.
LAD : Large sized vessel, 99% tight stenosis at proximal vessel.
Additional 70% lesion at very distal vessel (near the apex). Diagonal branches : D I-small sized vessel, minor plaguing at mid vessel. Ramus Intermedius : Small sized vessel, normal.
Lex : Dominant, large sized vessel, normal.

The LeA artery was engaged with XB3-6F guide catheter.BMW guide wire was ad anced distally across the lesion. The lesion was predilated with Maverick 2.5x 15mm balloon at 0 atm pressure. Then Xience Pro-3.5x23mm stent deployed at 14 atm pressure.
Then same guide wire was advanced in LPDA artery.Direct stenting was done with Xien e Pro
2.25x12mm at 14 atm pressure.Final check angiogram showed well deployed stents in LAD and LPDA arteries with T MI 3 flow.
Note-The puncture site was sealed with 6F-Exoseal vascular device.

Thanks and Regards
Ravikiran.N

 

[Jim Pawloski]

Dear All,
I come across doubt with the below ot notes from my hospital. Doctor has used balloon and stent for two vessels. Should i code normal angioplasty 92980 and 92981 or balloon angioplasty in this case. kindly help me out.


Indication : Unstable angina. Catheters : lL3.5 and lR3.5-6F.
Contrast : Omnipaque 350 mg/ml, total 350ml.

Access : Right femoral artery. Medication : NS, Heparin and NTG. LM : Normal.
LAD : Large sized vessel, 99% tight stenosis at proximal vessel.
Additional 70% lesion at very distal vessel (near the apex). Diagonal branches : D I-small sized vessel, minor plaguing at mid vessel. Ramus Intermedius : Small sized vessel, normal.
Lex : Dominant, large sized vessel, normal.

The LeA artery was engaged with XB3-6F guide catheter.BMW guide wire was ad anced distally across the lesion. The lesion was predilated with Maverick 2.5x 15mm balloon at 0 atm pressure. Then Xience Pro-3.5x23mm stent deployed at 14 atm pressure.
Then same guide wire was advanced in LPDA artery.Direct stenting was done with Xien e Pro
2.25x12mm at 14 atm pressure.Final check angiogram showed well deployed stents in LAD and LPDA arteries with T MI 3 flow.
Note-The puncture site was sealed with 6F-Exoseal vascular device.

Thanks and Regards
Ravikiran.N

I would code for just the drug eluting stent in the circumflex as angioplasty is bundled.
HTH,
Jim Pawloski, CIRCC