jdmjine
Contributor
our provider attempted PCI of the lad and diagonal branch after successfully doing LHC can I use the code 92920 with modifier, and what modifier should I use 52 or 53
"Decision was made to proceed w/ balloon angioplasty and cutting ballon angioplasty od the mid LAS in-stent restenosis. The pt was given IV angiomax according to the protocol and he was given 150mg of Plavix as a bolus. After this, initially a JL5 guide catheter was used and 1 BMW wire was placed in the LAD. The second one was in the first diagonal branch where the stents were originating. After this, a cutting balloon was attempted to cross, however, it made a lot of resistance and not enough backup guide support and all the wire came back, After this, an XBLAD 4.5 guide catheter was placed in the left main coronary artery. After this, BMW wire was again crossed into the LAD, only 1 wire was used. Again, a second attempt was made to put the cutting balloon through the stenosis; however it did not give enough support and the cutting balloon would not cross the proximal portion of the stent and it is most probably because of the significant tortuosity in the midportion of the lesion. At this point, no further attempts were made. The guide catheter and wire were removed. Subsequently the pt. did develop some substernal chest discomfort at 7/10 he was started on IV nitroglycerin up to 35mcg, which relieved his chest pain. "
Thank You
"Decision was made to proceed w/ balloon angioplasty and cutting ballon angioplasty od the mid LAS in-stent restenosis. The pt was given IV angiomax according to the protocol and he was given 150mg of Plavix as a bolus. After this, initially a JL5 guide catheter was used and 1 BMW wire was placed in the LAD. The second one was in the first diagonal branch where the stents were originating. After this, a cutting balloon was attempted to cross, however, it made a lot of resistance and not enough backup guide support and all the wire came back, After this, an XBLAD 4.5 guide catheter was placed in the left main coronary artery. After this, BMW wire was again crossed into the LAD, only 1 wire was used. Again, a second attempt was made to put the cutting balloon through the stenosis; however it did not give enough support and the cutting balloon would not cross the proximal portion of the stent and it is most probably because of the significant tortuosity in the midportion of the lesion. At this point, no further attempts were made. The guide catheter and wire were removed. Subsequently the pt. did develop some substernal chest discomfort at 7/10 he was started on IV nitroglycerin up to 35mcg, which relieved his chest pain. "
Thank You