Cardiology Coding Alert

Question: How should I report this procedure?

• Atherectomy in the proximal and mid right coronary artery
• Angioplasty of the proximal, mid, and distal right coronary artery
• Stenting of the proximal, mid, and distal right coronary artery

West Virginia Subscriber

Answer: Assuming the procedure is not related to an acute myocardial infarction (AMI) or chronic total occlusion (CTO), you should report 92933-RC (Percutaneous transluminal coronary atherectomy, with intracoronary stent, with coronary angioplasty when performed; single major coronary artery or branch; Right coronary artery).

This code represents atherectomy, angioplasty, and stenting in a single major coronary artery. The fact that the cardiologist performed services in the proximal, mid, and distal portions will not change your coding because they’re all part of the same vessel.

As noted above, you have different options if the service is during an AMI or treats CTO:

• AMI: 92941, Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel
• CTO: 92943, Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; single vessel.

Both 92941 and 92943 cover “any combination of intracoronary stent, atherectomy and angioplasty” performed in a single vessel, according to their code descriptors.