Wiki Cath, PCI and Stenting

[bennieyoung]

One doctor in our practice did a left heart catheterization, limited coronary angiography, percutaneous coronary intervention and stenting of the obtuse marginal branch and the nondominant circumflex artery. We coded 93458-26, 92928-LC, 92929-OM. Later that day the patient was having a lot of persistent pain post -percutaneous coronary intervention so a different doctor in our practice did a limited coronary angiogram for a brief relook to make sure that the stent was patent and that there were no complications. How would I code this in light of how the previous report was coded?

 

[Jess1125]

One doctor in our practice did a left heart catheterization, limited coronary angiography, percutaneous coronary intervention and stenting of the obtuse marginal branch and the nondominant circumflex artery. We coded 93458-26, 92928-LC, 92929-OM. Later that day the patient was having a lot of persistent pain post -percutaneous coronary intervention so a different doctor in our practice did a limited coronary angiogram for a brief relook to make sure that the stent was patent and that there were no complications. How would I code this in light of how the previous report was coded?

Well, if this was truly a coronary angiography you would have code 93454.26. This would be a diagnostic cath that could be billed as the patient was having pain post-cath. I haven't looked at the NCCI edits or anything but you may need a modifier on here since the patient had the prior cath earlier in the day to denote that this was a separate session. Probably a -59 for sure since you had the 92928 being billed on this day as well.

Jessica CPC, CCC

 

[bennieyoung]

I had thought about using that but wondered if the 77 modifier would be appropriate in this case?