Wiki Left Ventriculogram with stent.

[Determined1]

A 75-year-old female, Medicare patient, has been having angina. She has a past history of hypertension, type II diabetes and an old MI (myocardial infarction). Her cardiologist recommended an outpatient cardiac catheterization. After arriving in the cardiac catheterization lab, the patient was prepped with Versed and injected with lidocaine in the groin. The cardiologist threaded the Double Judkin’s catheter through the femoral artery for selective catheter placement and injection of Isovue into coronary arteries. A left ventriculogram was performed with no gradient across the aortic valve. The physician found 98% blockage resulting in coronary artery disease of the Obtuse marginal and Right Coronary artery. It was determined that the patient needed to have an angioplasty of these arteries. Next, the physician inserted a balloon catheter, crossing both the Obtuse and RCA lesions successfully, dilating both of the lesions and a drug eluting stent was deployed for each artery.

The cardiologist listed the procedures as: left heart catheterization, coronary angiogram, left ventriculogram, (Fluoroscopic) and coronary angioplasty with stent insertion.

Following the procedure, the patient was monitored. No post procedure complications were observed and the patient was sent home with instructions to call the doctor if any problems developed. Otherwise, see the cardiologist in 1 week.

Any suggestions?? I CANNOT figure this out! I was thinking 93458-26 59, 92928

 

[lisabatts79]

I agree with your coding. Good job! I code this everyday.

 

[espressoguy]

The physician found 98% blockage resulting in coronary artery disease of the Obtuse marginal and Right Coronary artery. It was determined that the patient needed to have an angioplasty of these arteries. Next, the physician inserted a balloon catheter, crossing both the Obtuse and RCA lesions successfully, dilating both of the lesions and a drug eluting stent was deployed for each artery.

Any suggestions?? I CANNOT figure this out! I was thinking 93458-26 59, 92928

Close.

The obtuse marginal is a branch of the left circumflex so you can code for the stents in both the OM and the RC.

93458-26,59; 92928-LC; 92928-RC.

Also, if properly documented, you can code 99152 for the versed (conscious sedation - this is new for 2017).