Wiki cath and stenting

[valleycoder]

When would it be appropriate to bill Medicare for both a 92928 (stent PCI) and 93458 (cath)? There is a CCI edit with indicator of 1 so it can be billed under the right circumstances but what circumstance would that be? If the provider performs a full cath (93458) and then stents the RCA (92928), would this be the correct circumstance to bill both, with a 59 on the cath code (93458)?

thanks in advance for your help!

 

[lady2wise]

As long as your documentation supports doing a left heart cath and the stenting, you can use both codes with a 59 modifier on the cath.

 

[TWinsor]

When would it be appropriate to bill Medicare for both a 92928 (stent PCI) and 93458 (cath)? There is a CCI edit with indicator of 1 so it can be billed under the right circumstances but what circumstance would that be? If the provider performs a full cath (93458) and then stents the RCA (92928), would this be the correct circumstance to bill both, with a 59 on the cath code (93458)?

thanks in advance for your help!

You can only bill for a LHC w/stent if there is no prior diagnostic cath performed.

HTH