Wiki PTCA in Saph Vein Bypass

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dpumford

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I have been reading some of these threads and AMA but I still did not see what I am looking for. So hope someone can assist me:eek:

Pt had a PTCA of the retrograde limb of the OM which had sever stenosis therefore this was wired. the wire was unable to transverse down the retrograde limb of the LC artery. A 2 mm balloon was successfully used for angioplasty of the anastomosis of the saphenous vein graft to the retrograde limb of the OM.. Unfortunately, there was poor guide support and unable to pass any larger balloon without loosening wire placement.Due to the increased us of contrast, Angioplasty was deemed final and nor further intervention was performed.

I am torn if I should code 92920 or 92937. I am leading toward 92937. Could anyone give me direction on which code is correct and why! I think I maybe I may be over thinking this Ugh! :confused:

Thanks in advance
 
dpumford said:
I have been reading some of these threads and AMA but I still did not see what I am looking for. So hope someone can assist me:eek:

Pt had a PTCA of the retrograde limb of the OM which had sever stenosis therefore this was wired. the wire was unable to transverse down the retrograde limb of the LC artery. A 2 mm balloon was successfully used for angioplasty of the anastomosis of the saphenous vein graft to the retrograde limb of the OM.. Unfortunately, there was poor guide support and unable to pass any larger balloon without loosening wire placement.Due to the increased us of contrast, Angioplasty was deemed final and nor further intervention was performed.

I am torn if I should code 92920 or 92937. I am leading toward 92937. Could anyone give me direction on which code is correct and why! I think I maybe I may be over thinking this Ugh! :confused:

Thanks in advance
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I think I would go with 92937 because they are actually stating anastomosis of the vein graft.So it seems to me that it was ballooned on the graft side.
 
92937 is a combination code, he never mentions a stent or atherectomy, therefore I would use 92920. If stated the intention was to perform a stent and was not able to then I would use 92937, 52.
 
If the PTCA was done in the Bypass or by going thru the bypass you have to use the bypass codes. CPT 92920 is only for Coronary branches not bypass Branches.

I think the confusion is with the wording "any combination" but what this means is any method of revasculation wether it be PTCA, Stent and/or atherectomy individually or combination of the three. For example if just a stent was done either in or via a bypass it would be 92937. Same with an atherectomy only; this is also true for the PTCA only.

If you have Zhealth account they have good information on understanding the hierarchy of these codes.

Free on the AAPC site there is a good doc by Dr Dunn with case examples. http://news.aapc.com/index.php/2013/01/changes-plus-more-changes-for-cardiology-in-2013/


HTH,

Misty Sebert CPC, CCC
 
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