93458- cath inlcuded in 92980 stent

dcrider

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Loveland, CO
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I am looking for were I can obtain the guidelines / verbage showing that the cath is reimbursed separately from the stent if the physician did not know that the stent was going to be done. My doctor wants it in writing. Can anyone direct me? :confused:

Thanks
 

Jess1125

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Green Bay
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I am looking for were I can obtain the guidelines / verbage showing that the cath is reimbursed separately from the stent if the physician did not know that the stent was going to be done. My doctor wants it in writing. Can anyone direct me? :confused:

Thanks
This is copied from Medicare's CCI National Policy Manual:

16. Percutaneous coronary artery interventions (e.g., stent, atherectomy, angioplasty) include coronary artery catheterization, radiopaque dye injections, and fluoroscopic guidance. CPT codes for these procedures (e.g., 93454-93461, 76000) should not be reported separately. If medically reasonable and necessary diagnostic coronary angiography precedes the percutaneous coronary artery intervention, a coronary artery or cardiac catheterization and associated radiopaque dye injections may be reported separately. However, fluoroscopy is not separately reportable with diagnostic coronary angiography or cardiac catheterization.

Jessica CPC, CCC
 
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