Cardiology Question for the Week of June 19, 2023

Question:

How would we code for the following scenario? 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.

Answer:

In a physician setting, you would code 92928-LD, 92920-RC. However, in a hospital setting you would 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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