Cardiology Coding Alert

Question: Can I charge a cath (93510) and stent (92980) together when the same cardiologist performs them at the same session? Is the cath part of the stenting procedure?

Maine Subscriber

Answer: If the catheterization procedure was diagnostic (meaning, not guide shots for the stent) and the findings necessitated the intervention, you can bill 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous) and 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) together.

Make sure you add modifier 59 (Distinct procedural service) to codes 93555-26 (Imaging supervision, interpretation and report for injection procedure[s] during cardiac catheterization; ventricular and/or atrial angiograph; professional component) and 93556-26 (... pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]) whenever you're reporting 92980. Otherwise your carrier will deny these services.

Also, in rare cases, some carriers will require modifier 59 on 93545 (Injection procedure during cardiac catheterization; for selective coronary angiography [injection of radiopaque material may be by hand]).

Don't forget: When you report the stent, you should use anatomical modifiers LC (Left circumflex or LCX), RC (Right coronary or RCA) or LD (Left anterior descending or LAD).