Wiki 92980 and Modifier 22

[mdziubek]

Hello all you marvolous Coding geniuses out there.
Here are my 2 question:
1.) If stents are placed in multiple branches of a single vessel, is it appropriate to add a 22 modifier to the 92980, since (if I am correct) you can only code one stent placement per vessel?
2.) Also I'm in the process of explaining why my cardiologist can't charge for multiple sents in a single vessel and would love some printable proof for him. Any suggestions? Thank you so much for your help!!!
Maggie D.

 

[hewitt]

Here is some coding guidance. The Nordic article may be what you are looking for.... "Compliance Note: CPT codes 92980, 92981, 92995 and 92996 are all-inclusive therapeutic intervention codes. Consequently, the billing of an unlisted CPT code for use of the "cutting" balloon device along with CPT codes 92995 and 92996, with or without CPT codes 92980 and 92981, is inappropriate, since the "cutting" balloon device is an integral part of the interventional CPT codes 92995 and 92996. Reference:Interventional Cardiology Medical Policy (Noridian Administrative Services LLC)

(Codes 92980, 92981 are used to report coronary artery stenting. Coronary angioplasty [92982, 92984] or atherectomy [92995, 92996], in the same artery, is considered part of the stenting procedure and is not reported separately. Codes 92973 [percutaneous transluminal coronary thrombectomy] and 92974 [coronary brachytherapy] are add-on codes for reporting procedures performed in addition to coronary stenting, atherectomy, and angioplasty and are not included in the 'therapeutic interventions' in 92980). Codes 92978 and 92979 are add-on codes for reporting intravascular ultrasound procedures performed in addition to coronary and bypass graft diagnostic and interventional services."

 

[donnajrichmond]

Hello all you marvolous Coding geniuses out there.
Here are my 2 question:
1.) If stents are placed in multiple branches of a single vessel, is it appropriate to add a 22 modifier to the 92980, since (if I am correct) you can only code one stent placement per vessel?
2.) Also I'm in the process of explaining why my cardiologist can't charge for multiple sents in a single vessel and would love some printable proof for him. Any suggestions? Thank you so much for your help!!!
Maggie D.

The first proof is the code description for 92980 which says "stent(s)".
Second, if you have the AMA / ACC 2012 Reference Guide for Cardiovascular Coding, this explains the policies for billing cardiac interventions, including the 3 major vessels (for Medicare - 4 otherwise), concept of "single vessel", and other issues. It states "The CPt descriptor for code 92980 contains the phrase "transcatheter placement of intracoronary stent(s)," indicating that the code is used only once, no matter how many stents are placed in the same vessel."

And be prepared, the codes for coronary interventions are all changed for 2012.