Cardiology Coding Alert

Reader Question:

Report Next-Day Interventions After Heart Cath

Question: One of our patients had a left-heart catheterization on Thursday and returned to the catheterization lab on Friday for a percutaneous transluminal coronary angioplasty (PTCA) and brachytherapy. Can I bill 93508-26 and 93556-26 with the PTCA and brachytherapy since he had catheterization the day before?

Wisconsin Subscriber

Answer: Because the physician performed the heart catheterization on one day and performed both the PTCA and brachytherapy on the next day, you would report only 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel) and +92974 (Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy [list separately in addition to code for primary procedure]) for the second day's services.

Remember that you cannot bill "guiding" shots for catheter-based interventions that can stand alone, such as the PTCA. And you would bill procedures that are considered "add-on," such as brachytherapy (92974), with a primary procedure. Thus, when the physician performs PTCA and brachytherapy on the same day during the same encounter, all you can bill is 92982 and 92974.

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