1formissy
Guru
Hello All,
I really need some help on this OP report. I have an office appealing the original decision we made on a claim, (I am on the payers side), and I want to make sure I understand the procedures which were performed. Could someone please take a look at this report, and let me know how you would code it? I would REALLY APPRECIATE IT!
This is how the provider's office is reporting the claim. (MUE's 92928 is only 1)
92928-LD
92928-RC
93458-26
**************************
Indication: Angina with prior coronary stenting.
Name of Procedures:
Left Heart Catheterization
Selective coronary artery angiography
Left ventriculography
PTCA and stenting of the PDA
PTCA and stenting of the diagonal branch
Radiological supervision and interpretation
Conscious sedation
CORONARY ARTERY ANGIOGRAPHY: Left main: There is calcification noted in the walls of the left main without any area of ciritcal stenosis.
Left enterior descending artery: There was calcification noted in the walls of the left anterior descending aretery without any area of signifiant stenosis.
There is a moderate size first diagonal branch, which has an in-stent restenosis of 90%. A 2.5 x 16 mm drug-eluding stent was deployed with 0% residual stenosis.
Left circumflex artery: Left circumflex artery and its OM branches had minor irregularities.
Right coronary artery is a large right dominant right coronary artery. There is a stent noted in the mid RCA. There is an area of in-stent restenosis of 30% to 40%. The PL branch had a 90% lesion, which was stented using a 2.75 x 20 mm drug-eluting stent with 0% residual stenosis. The PDA had minor irregularities. Left ventriculography showed an ejection fraction of 45% to 50%. There was no gradient across the LVOT.
I really need some help on this OP report. I have an office appealing the original decision we made on a claim, (I am on the payers side), and I want to make sure I understand the procedures which were performed. Could someone please take a look at this report, and let me know how you would code it? I would REALLY APPRECIATE IT!
This is how the provider's office is reporting the claim. (MUE's 92928 is only 1)
92928-LD
92928-RC
93458-26
**************************
Indication: Angina with prior coronary stenting.
Name of Procedures:
Left Heart Catheterization
Selective coronary artery angiography
Left ventriculography
PTCA and stenting of the PDA
PTCA and stenting of the diagonal branch
Radiological supervision and interpretation
Conscious sedation
CORONARY ARTERY ANGIOGRAPHY: Left main: There is calcification noted in the walls of the left main without any area of ciritcal stenosis.
Left enterior descending artery: There was calcification noted in the walls of the left anterior descending aretery without any area of signifiant stenosis.
There is a moderate size first diagonal branch, which has an in-stent restenosis of 90%. A 2.5 x 16 mm drug-eluding stent was deployed with 0% residual stenosis.
Left circumflex artery: Left circumflex artery and its OM branches had minor irregularities.
Right coronary artery is a large right dominant right coronary artery. There is a stent noted in the mid RCA. There is an area of in-stent restenosis of 30% to 40%. The PL branch had a 90% lesion, which was stented using a 2.75 x 20 mm drug-eluting stent with 0% residual stenosis. The PDA had minor irregularities. Left ventriculography showed an ejection fraction of 45% to 50%. There was no gradient across the LVOT.