Attempted/Failed angioplasty Coding


Larksville, PA
Best answers
Patient had a cardiac cath 4 weeks prior this procedure. A sheath was inserted in the right femoral artery, followed by a 6 French JL4. Cine ang revealed a 98 percent left main, involving the ostium of the LAD and teh circumflex, severe second diagonal stenosis adn moderately severe to severe first diagonal stenosis. A Hi-Torque floppy was passed down the vessel with some difficulty. It was difficult to pass the calcified left main. Finally able to get it down. A 2.0 x 12 balloon would not pass. A 1.5 balloon was used. The guiding catheter was all the way up to the lesion. Despite this the balloon would not pass. Because it was a heavily calcified vessel and this was not a major vessel and because of renal insufficiency, we felt the ROTO blade would not be appropriate. Procedure was aborted adn the angioplasty was unsuccessful since the balloon would not pass.

How would you code this? Would it be 92982-74 or would you code this as a left heart catherization even though the patient just had one less then 4 weeks prior? Or would it be something totally different?