Cardiology Coding Alert

Question: Can we report two units of 92928 for two stents that our physician inserted in two coronary arteries?

Ohio Subscriber

Answer: Assuming that your physician inserted the two stents during a common procedure on two major arteries, it would be incorrect if you submit one line item with two units of 92928 (Percutaneous transcatheter placement of intracoronary stent[s], with coronary angioplasty when performed; single major coronary artery or branch). Each individual major coronary artery must be identified separately and each artery would receive its own line item modified with the appropriate modifiers (LD, RC, LC, RI, LM). Therefore, you should report 92928 twice using a distinct line for each artery.

If one major artery and branch receive a stent, you should report 92928 only once. Additionally, you would submit the add-on code +92929 (Percutaneous transcatheter placement of intracoronary stent[s], with coronary angioplasty when performed; each additional branch of a major coronary artery [List separately in addition to code for primary procedure]) for the second stent.

Coding tip: There are five major arteries LAD (LD), RCA (RC), LCX (LC), Ramus (RI), and Left Main (LM). You may report each additional coronary artery branch(s) only on three major arteries (LAD, RCA, and LCX). And you may report only up to two branches for these three major arteries during the same session. Code a single base code (initial) from a family (LAD, RCA, LCX, Ramus, and Left Main). The LAD branches consist of diagonals; RCA branches consist of posterolaterals and posterior descending artery, called the PDA (in right dominant patients). The LCX branches consist of obtuse marginals and PDA (in left dominant patients).

Check C codes for drug eluting stents: For Medicare hospital billing, you must report the appropriate C codes, C9600 (Percutaneous transcatheter placement of drug eluting intracoronary stent[s] with coronary angioplasty when performed; single major coronary artery or branch) through C9608 (Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft [List separately in addition to code for primary procedure]). When coding for a facility there are 9 C-codes to consider that replaces the numeric (i.e., 92928) procedural codes.