Wiki Left Main

[kessel]

If a stent was placed in the left main is it possible to bill for this and if so what modifier would you use with the 92980?

 

[Jim Pawloski]

If a stent was placed in the left main is it possible to bill for this and if so what modifier would you use with the 92980?

I bill for left main as one of the branches. So if the wire goes down the LAD to deploy the stent, I use LD. If the LAD and the Main were stented, I bill the main as the LC.
HTH,
Jim Pawloski, CIRCC

 

[Robbin109]

According the American College of Cardiology:
"-the approach most consistent with existing policy is as follows: consider the LMCA as a major artery when a lesion is treated in the left main only. When separate lesions are treated in the LMCA and either the LD or LC, code for only one intervention."

and...

According to the Dr Z's Diagnostic & Interventional Cardiovascular Coding Reference:

"For coding purposes, the left main is considered to be part of this vessel's distal distribution (eg, if intervention is performed in the LD and the left main, the intervention in the left main is bundled into the LD intervention). Only the highest level of vessel intervention performed in these vessels is coded. Do not code the left main intervention separately from an LD or LC intervention. If LD and left main intervention is performed, do not code the left main as an LC intervention to "get around" these rules. Only if there is an additional separate and distinct intervention performed in the LC distribution would one bill additionally for an LC intervention."