Wiki Additional vessel 92921 + DES stent

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MrsApplegate

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Does anyone know how to properly code this? This is a hospital OP facility. DES stent in the LD with PTA only in the 2nd diagonal. We coded this C9600 + 92921 and it's hitting an edit due to missing base code for 92921. The descriptor for 92921 says this can only be used with base codes 92920, 92924, 92928, 92933, 92937, 92941, and 92943. Is this just an oversight by CMS or am I missing something?:confused:
 
Chandler,
The C9600 is the code that covers the stent. The PTA should 92920. Although its the same "branch" 1 procedure is the stent and the other is the angioplast without a stent. This is my take on it. Hope I've helped.
Mary Beth Przychocki, CPC
 
mbprzychocki said:
Chandler,
The C9600 is the code that covers the stent. The PTA should 92920. Although its the same "branch" 1 procedure is the stent and the other is the angioplast without a stent. This is my take on it. Hope I've helped.
Mary Beth Przychocki, CPC
Click to expand...

I agree with you, but the PTA should be 92921, additional branch.
HTH,
Jim Pawloski, CIRCC
 
Looking in AAPC's January's Cutting Edge, page 41, it gives the example of a stent in native LC and angioplasty is performed in two branches of the LC. Codes would be 92928 and 92921 x 2.
 
Coding of 1 stent and 1 angioplasty

If you are coding 1 stent and 1 angioplasty it should be coded 92928 (main or branch stent) and 92920 (main or branch angioplasty). 92921 is an add on code for an ADDITIONAL branch angioplasty. 92921 would only be used if the provider were performing a second branch angioplasty in a 2nd branch. It would not be used unless 92920 had already been used. Just as 92929 would not be used unless 92928 had already been used. I realize the paranthetical statement under 92921 in the CPT book leads you to believe that 92921 can be used with 92928... However, I believe that statement is inaccurate. You can used 92921 with 92928, as long as you use 92920 first.

Jennifer Haney, CPC, CCC
 
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The AAPC Cutting Edge article would be correct. If you have stenting done in the circumflex and angioplasty alone was done in 2 different branches of the circumflex it IS correctly coded as 92928 and then 92921 x2.

You don't HAVE to have 92920 in order to bill the 92921. You just have to bill one of the "base" codes.

Jessica CPC, CCC
 
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