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How would we code for the following when it comes to hospital-based services: An interventional cardiologist performs a PTCA in the LAD followed by drug-eluting stent placement in the same vessel, subsequently the physician next performs a PTCA in the RCA.
For hospital-based services, code C9600-LD, 92920-RC. The PTCA in the LAD may not be billed, as it is the lesser-valued intervention in the same vessel as another intervention of greater weight (the stent). The PTCA in the RCA is separately coded because it is a different major coronary vessel. Current coding rules state that you must have a single base/initial vessel code in each of the five primary coronary arteries before add-on codes are assigned, therefore the PTCA primary code must be billed for the angioplasty in the RCA.
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