Cardiology Coding Alert

Question: May I report 92975 for TPA with stent code 92980, or is the TPA included? I see that a modifier is allowed, but under what circumstance would this be correct coding?

Codify Member

Answer: The Correct Coding Initiative (CCI) edit that bundles 92975 (Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography) into 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) tells you not to code the two together unless they are distinct procedures.

In other words: You may consider reporting both codes for the same date when the physician performs them at different encounters or anatomic sites. To override the edit, you should append modifier 59 (Distinct procedural service) to 92975.

To learn more about proper modifier 59 use, check out CMS's Modifier 59 Article at www.cms.gov/NationalCorrectCodInitEd/Downloads/modifier59.pdf.