When using intravenous ultrasound (IVUS) for sequential lesions in the distal left main (LM) and proximal left anterior descending (LAD), intervention consisted of single stent. Is IVUS billed as initial 92978, or is it initial 92978 and additional 92979?


If there were separate lesions evaluated by IVUS in the LM and in the LAD, then you would report the following:

+92978 Endoluminal imaging of coronary vessel or graft using IVUS or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure)
+92979 each additional vessel (List separately in addition to code for primary procedure)

However, if there was a single bridging lesion that spanned both arteries, then only 92978 would be reported.


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