Wiki Angioplasty vs. stent

[Jim Pawloski]

I had a dictation where the physician performed an angioplasty on the lt subclavian and lt renal artery. In the dictation, it is stated that because of a suboptimal results, a stent was placed. With that said, can both the PTA and stent be charged. I thought it was if there is a dissection or the stenosis remained more that 50%, then you can bill for both. I heard at a coding seminar that the comment "suboptimal result" is not good enough reason for billing for both. Any comments?

Thanks,
Jim Pawloski CIRCC, R.T. (CV)

 

[wwsteves]

My understanding is that if the original intention is to only perform angioplasty, and a stent is then placed because of unacceptable results of the angioplasty, then both can be billed.

 

[dpeoples]

I had a dictation where the physician performed an angioplasty on the lt subclavian and lt renal artery. In the dictation, it is stated that because of a suboptimal results, a stent was placed. With that said, can both the PTA and stent be charged. I thought it was if there is a dissection or the stenosis remained more that 50%, then you can bill for both. I heard at a coding seminar that the comment "suboptimal result" is not good enough reason for billing for both. Any comments?

Thanks,
Jim Pawloski CIRCC, R.T. (CV)

You can charge both interventional procedures as long as the suboptimal result of the plasty is documented. However, if the original intent was to stent and the stenosis was "predilated", documenting suboptimal results might not hold up to close scrutiny.

I am usually reluctant to charge both if there is any doubt of intent/medical necessity etc...

HTH