A left heart catheterization (LHC) was performed on a Medicare patient, then a drug-eluting stent (DES) was placed in the left anterior descending artery (LAD), and an angioplasty of the diagonal branch was performed. What can the hospital charge here?


If a diagnostic LHC with coronary angiography is performed with DES in the LAD and percutaneous transluminal coronary angioplasty (PTCA) in a diagonal, the following are the codes to assign. Be sure to append modifier -59 to code 93458. Since the diagonal is a branch of the LAD, you report an “additional branch” code.

For the LHC:

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed

For the DES to the LAD:

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

For the PTCA of the diagonal branch:

Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)


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