Cardiology Coding Alert

Question: How should I code an attempted angioplasty? The physician completed the left heart catheterization but was unable to cross the lesion and perform the percutaneous transluminal coronary angioplasty despite several attempts. Should I use modifier -52?

Hawaii Subscriber  
Answer: It depends on whether the cardiologist attempted to cross the lesion with wires or with balloons. If wires alone were used, 93510 (left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous) should be reported without billing for the attempted angioplasty. If the cardiologist tried getting a balloon to cross the lesion, the angioplasty should be reported as 92982 (percutaneous transluminal coronary balloon angioplasty; single vessel) with modifier -52 (reduced services).