Wiki Cardiac Catherization Help

[coding4fun]

Procedures Performed:
1. Coronary angiography of the left system, no angiography of the right
2. Angiomax administration
3. Right common femoral artery access 6-French catheter
4. Coronary angiography of the left system
5. Balloon angioplasty of the 2nd diagonal branch
6. Balloon angioplasty of the LAD
7. Unsuccessful deployment of any stents into the diagonal branch or the LAD due to heavy calcification and a previous stent in the LAD which was restenosed.
8. Balloon angioplasty fo the proximal and distal circumflex artery, followed by placement of a proximal 2.25 x 24mm Promus stent followed by overlapping Promus 2.25 x 20mm stent. There were post dilated to high pressure. The stents were post dilated with the deployment balloons. The patient received during the procedure multiple doses of intracoronary nitroglycerin in the left main trunk for visualizing both the LAD and diagonal branch and the circumflex artery.

Stuck, could you guys pleeeeaaase help! Am new to cardio coding and I am driving myself crazy with possibillities. Thanks!

 

[dblakema@svmh.com]

93458 for angiogram of coronaries and crossing the valve into the left ventricle...must have an LV measurement at least...If an LV gram was performed that is sufficient.

Angiomax administration if there is a start and stop time then you can use the infusion codes...96365..usually angiomax runs just during the case

The access is considered bundled into the procedure

92920 for PTCA (percutaneous transluminal balloon angioplasty) of LAD

92921 for PTCA of diagonal branch

You can charge for the equipment...but if the physician was unsuccessful in the deployment of stents than you cannot charge the code for stent deployment

If the proximus stent is a bare metal stent then you would code 92928 for stent deployment to the proximal and distal circumflex artery. It does not matter how many stent are in a single major coronary artery ...you can only charge one intervention code per single coronary vascular family...

There are 5 coronary recognized vascular families LM, RI, LAD, CX, LAD and RCA. There are no recognized branches to LM or RI...The recognized branches of the LAD are diagonals; Cx has OM or obtuse marginals and RCA has the PDA and PL branches that are recognized

You may have more than one initial if you are dealing with more than one vascular family.

I hope this helps!
Dorothy Blakeman, CCC, CCS, CCS-P