Question:

What code would I use for the second stent if the doctor’s dictation states “MI with culprit lesions in the LAD and RC”? If I can only assign code 92941 one time, what code do I use for the additional artery?

Answer:

If the patient is having an acute myocardial infarction (AMI) with culprit lesions in both the left anterior descending (LAD) artery and right coronary (RC), which would be rare, you would only assign 92941 once for the professional component (PC) or for the facility when a bare metal stent is placed.

92941 Percutaneous transluminal revascularization of acute total/subtotal occlusion during AMI, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

If a drug-eluting stent (DES) was placed, you would report the following level II code for the facility instead of 92941:

C9606 Percutaneous transluminal revascularization of acute total/subtotal occlusion during AMI, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel

The second major coronary artery stenting would be reported using the normal stent codes (92928) for the PC or for the facility if a bare metal stent was placed. If a DES was placed in the RC, you would report C9600 for the facility instead of 92928.

92928 Percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch
C9600 Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch

 

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