Good morning fellow coders!
Any coders specialized in cardiac catheterization can assist me please?
I'm new to this dept and am not sure which anatomic modifier(s) apply to this cardiac catheterization report-- LC, LD, LM, RC, RI for CPT codes 92928, 92929, 92950 and if I'm able to append more than one modifier for CPT 92928, ,92929, 92950?
Does the anatomic modifiers apply to access point of cath procedure "Right radial artery" or the arteries that were performed during cath procedure LAD, LCX, RCA as documented in the report? I'm a bit confused.
Thanks in advance for your assistance--greatly appreciate it!
Cardiac surgeon billed CPT codes as:
36556
33990
93458--59
92928
92929
92950
76937
The Cardiac Cath report is documented as:
Indication of cath: NSTEMI
Access: Right radial artery
Cath showed:
1) No angiographically significant disease in LM
2) High grade stenosis in prox -mid LAD involving takeoff of D-1 with up to 99% stenosis. Mid LAD has 80% stenosis. Apical LAD has 90% stenosis.
3) Long lesion in OM-1 with up to 90% stenosis. Mid LCX 40% stenosis. OM-2 50% stenosis. Mid-distal LCX 60% stenosis.
4) Moderate-severe diffuse disease in prox-mid RCA with up to 70% stenosis, distal RCA has diffuse 50% stenosis. RPDA has severe diffuse disease.
- pLCx with 95% stenosis. Long lesion in OM-1 with up to 90% stenosis. Mid LCX 40% stenosis. OM-2 50% stenosis. Mid-distal LCX 60% stenosis.
- RCA: Not accessed
Patient was hemodynamically stabilized with Impella CP (via RCFA) placement and TVP (RFV)
- Informed consent was obtained.
- Time out was performed with the RN prior to proceeding with the procedure.
- After performing time out, local anesthesia at the right radial and rt groin was performed using 1% lidocaine.
- Site: RFA was accessed using 6F/12 cm sheath.
Just following administration of sedation and radial artery spasmolytic cocktail, patient become hypotensive with SBP<50, bradycardic. Brief CPR (<5min) was initiated as per ACLS protocol.
Intervention:
- Best guidewire used: Runthrough
- Guide Catheter used: CLS 3.5 (6F)
- Successful and uncomplicated Impella-assited PCI of OM1 with 2.25x26 mm Resolute Onyx DES resulting in TIMI III flow and no residual stenosis
- Successful and uncomplicated Impella-assited PCI of pLCx with 2 overlapping 3.5x12 mm Resolute Onyx DESs resulting in TIMI III flow and no residual stenosis
- Successful results with TIMI flow of 3.
Any coders specialized in cardiac catheterization can assist me please?
I'm new to this dept and am not sure which anatomic modifier(s) apply to this cardiac catheterization report-- LC, LD, LM, RC, RI for CPT codes 92928, 92929, 92950 and if I'm able to append more than one modifier for CPT 92928, ,92929, 92950?
Does the anatomic modifiers apply to access point of cath procedure "Right radial artery" or the arteries that were performed during cath procedure LAD, LCX, RCA as documented in the report? I'm a bit confused.
Thanks in advance for your assistance--greatly appreciate it!
Cardiac surgeon billed CPT codes as:
36556
33990
93458--59
92928
92929
92950
76937
The Cardiac Cath report is documented as:
Indication of cath: NSTEMI
Access: Right radial artery
Cath showed:
1) No angiographically significant disease in LM
2) High grade stenosis in prox -mid LAD involving takeoff of D-1 with up to 99% stenosis. Mid LAD has 80% stenosis. Apical LAD has 90% stenosis.
3) Long lesion in OM-1 with up to 90% stenosis. Mid LCX 40% stenosis. OM-2 50% stenosis. Mid-distal LCX 60% stenosis.
4) Moderate-severe diffuse disease in prox-mid RCA with up to 70% stenosis, distal RCA has diffuse 50% stenosis. RPDA has severe diffuse disease.
- pLCx with 95% stenosis. Long lesion in OM-1 with up to 90% stenosis. Mid LCX 40% stenosis. OM-2 50% stenosis. Mid-distal LCX 60% stenosis.
- RCA: Not accessed
Patient was hemodynamically stabilized with Impella CP (via RCFA) placement and TVP (RFV)
- Informed consent was obtained.
- Time out was performed with the RN prior to proceeding with the procedure.
- After performing time out, local anesthesia at the right radial and rt groin was performed using 1% lidocaine.
- Site: RFA was accessed using 6F/12 cm sheath.
Just following administration of sedation and radial artery spasmolytic cocktail, patient become hypotensive with SBP<50, bradycardic. Brief CPR (<5min) was initiated as per ACLS protocol.
Intervention:
- Best guidewire used: Runthrough
- Guide Catheter used: CLS 3.5 (6F)
- Successful and uncomplicated Impella-assited PCI of OM1 with 2.25x26 mm Resolute Onyx DES resulting in TIMI III flow and no residual stenosis
- Successful and uncomplicated Impella-assited PCI of pLCx with 2 overlapping 3.5x12 mm Resolute Onyx DESs resulting in TIMI III flow and no residual stenosis
- Successful results with TIMI flow of 3.
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