Cardiology Coding Alert

Reader Questions:

Figure Out This Atherectomy Situation

Question: After the patient was prepped and anesthetized, my cardiologist made an incision in the brachial artery and inserted a guidewire through it. They inserted a guide cath over the guidewire, moving it through the vascular system until they positioned the cath at the opening to the coronary artery. My cardiologist injected a dye and took fluoroscopic images to examine the blood flow and placement of the cath in the artery. They advanced a cath with a burr into the coronary vessel to destroy the material blocking the artery. During this same session, my cardiologist inserted a balloon-tipped cath to the coronary lesion and inflated the balloon to flatten the plaque against the artery wall. Next, they inserted a balloon-mounted cath with a stent to the stenosed site. My cardiologist also performed an angioplasty. What code should I report on my claim?

Alabama Subscriber

Answer: You should report 92933 (Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch) on your claim.

Don’t miss: Code includes an angioplasty when your cardiologist performs one. That means that an angioplasty is not required, but you should not report the angioplasty separately when your provider performs it. According to the documentation, your cardiologist did perform an angioplasty; however, you would just report 92933.

Atherectomy defined: An atherectomy is the removal of plaque from the lining of an artery.