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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.
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.
This question was answered in our Peripheral & Cardiology Coder. For more hot topics relating to cardiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
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