Wiki Heart Cath and Stent coding help

[abid]

Hello! I am new to cardiology billing and need help correctly coding the following scenerio:

Procedure Type:
1. Left Heart Cath and coronary angiogram
2. Left Ventriculogram
3. Right iliofemoral angiogram
4. Saphenous vein graft study
5. Left internal mammary artery study
6. PTCA of the ramus, proximal obstruction w/ 2.5 x 10mm balloon
7. A 3.5 x 15 Xience stent placement into proximal ramus vessel
8. A 3.75 x 8mm noncompliant balloon post dilatation

I would be happy to email the ops reports, tried to attach them and they were too big. Thank you in advance for any help.

 

[dimmitta]

Hope this helps

Hello! I am new to cardiology billing and need help correctly coding the following scenerio:

Procedure Type:
1. Left Heart Cath and coronary angiogram
2. Left Ventriculogram
3. Right iliofemoral angiogram
4. Saphenous vein graft study
5. Left internal mammary artery study
6. PTCA of the ramus, proximal obstruction w/ 2.5 x 10mm balloon
7. A 3.5 x 15 Xience stent placement into proximal ramus vessel
8. A 3.75 x 8mm noncompliant balloon post dilatation

I would be happy to email the ops reports, tried to attach them and they were too big. Thank you in advance for any help.

I would code this with a 92980 for the stent in the proximal ramus vessel. However, this will need either a LD or LC modifier for billing since the Ramus Intermedius is not considered one of the "main" heart vessels. Usually the RI will branch off the Left Circumflex but check the report or with the physician to be sure.

Then you would just need to bill a 93459 for the left heart cathertization with coronary angiogram and bypass graft angiograms. Also, according to new CCI edits this will need a 59 modifier when billed with an interventional code.

 

[abid]

Thank you for your help