Wiki Attempted plasty

[Amanedmaiston]

I need help on how to code this.

Summary of attempted percutaneous transluminal coronary angioplasty: The diagnostic catheters were removed and replaced with a right Judkins guiding catheter with side holes. Through the side holes, this catheter was then manipulated through the origin of the RCA. Through this catheter the intermediate metal-tipped guidewire was placed and negotiated across the areas of stenosis and stabilized in the distal portion of the posterior descending branch. At this point in the procedure 100 mcg of intracoronary nitroglycerin was given directly into the RCA. The next cina run demonstrated almost complete relief of the stenosis without any intervention actually being performed other than wiring the vessel. It was clear then that these were areas of spasm. There was a residual 30% narrowing in the early mid vessel and indeed the lesion before the posterior descending branch was completely resolved. The procedure was of course, obviously terminated at this point, since these were not true stenosis but composed of spasm of the RCA.

 

[j.monday7814]

you can't bill for any intervention and drug injections like this one are inclusive of the diagnostic procedure or intervention procedure. So, depending on the rest of the documentation you are probably looking at 93458 or 93454. Our physicians routinely inject nitro and other medications to reduce to coronary spasm

 

[jcrouch]

Jeremy is correct, you cannot bill for intacoronary nitro. The nitro treated the lesion without intervention, the fact that the doctor "planned" to do Angioplasty is not billable. It looks to me like he this is more of a preplanned angioplasty that didn't have to be performed, rather than attempted.