Cardiology Coding Alert

Question: Is 92982-52 appropriate if the cardiologist makes several attempts to pass a wire for PTCA but is unable to cross the lesion?

Kansas Subscriber

Answer: For the case you describe, you should append modifier 52 (Reduced services) to the appropriate percutaneous transluminal coronary angioplasty (PTCA) code, such as 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel).

Support: Principles of CPT Coding, Fourth Edition, offers an example in which the physician can't cross a lesion in the right coronary artery with the balloon catheter and states you should append 52 to the angioplasty code.

The procedure: In PTCA, the cardiologist threads a specialized guidewire through the blockage and passes a deflated balloon over the wire.-She inflates the balloon once it's in position, and creates a passageway by pushing the pliable blockage against the artery's sides.

Note that if the cardiologist crossed the lesion and performed the angioplasty but documented that the outcome was unacceptable, then you should not append modifier 52, Principles of CPT Coding states.