vidraj
Networker
Hello everyone,
Need opinion with CPT code for the interventional procedure below.
Procedure note:
The right radial artery was accessed via Seldinger technique, 6-French sheath was introduced. A 6-French EBU 3.75 guide was used to cannulate left main. Diagnostic angiography reveals patent left main at the ostium, body and the bifurcation.
Left anterior descending artery had a mid long 80% calcific lesion in a type 2 vessel with a quick taper off of the LAD beyond the apical diagonal.
BMW wire was advanced through the lesion with ease and parked into the apical LAD. The lesion was directly subjected to an intravascular lithotripsy using a shockwave device, 2.5 x 12 balloon at 2 atmospheres with 10 cycles of shock wave done twice in sequence through the length of the lesion without complications. Lesion opened up very smoothly. Lesion was then subjected to a direct stenting using a 2.75 x 26 Onyx drug-eluting stent and deployed at 22 atmospheres with good distal apposition. The stent was then post dilated with a 3.0 NC balloon in the mid and distal parts with adequate stent apposition to the arterial walls. There was haziness in the proximal part of the stent at the bend of the artery and hence another 3.5 x 8 Onyx drug-eluting stent was deployed in overlapping manner at 16 atmospheres and post-dilated at 14 atmospheres in the overlapping segment with excellent angiographic results without complications. The patient tolerated the procedure well.
325 mg of aspirin and 300 mg of additional Plavix was given on the day of the procedure post angioplasty. ACT was monitored throughout the case as needed. Heparin was given for anticoagulation.
Procedure was completed without complications.
CONCLUSIONS: Successful shock wave lithotripsy and angioplasty with stent deployment in the mid LAD using a 2.75 stent as well as a 3.5 stent in overlapping manner with excellent angiographic results without complications.
I couldn't find a specific CPT CODE for Coronary Shockwave Lithotripsy.
- Can we consider this as Atherectomy and code it as 92933 - LD ?
Or
- is this considered part of angioplasty and code as 92928 - LD Only?
TIA
Vid.
Need opinion with CPT code for the interventional procedure below.
Procedure note:
The right radial artery was accessed via Seldinger technique, 6-French sheath was introduced. A 6-French EBU 3.75 guide was used to cannulate left main. Diagnostic angiography reveals patent left main at the ostium, body and the bifurcation.
Left anterior descending artery had a mid long 80% calcific lesion in a type 2 vessel with a quick taper off of the LAD beyond the apical diagonal.
BMW wire was advanced through the lesion with ease and parked into the apical LAD. The lesion was directly subjected to an intravascular lithotripsy using a shockwave device, 2.5 x 12 balloon at 2 atmospheres with 10 cycles of shock wave done twice in sequence through the length of the lesion without complications. Lesion opened up very smoothly. Lesion was then subjected to a direct stenting using a 2.75 x 26 Onyx drug-eluting stent and deployed at 22 atmospheres with good distal apposition. The stent was then post dilated with a 3.0 NC balloon in the mid and distal parts with adequate stent apposition to the arterial walls. There was haziness in the proximal part of the stent at the bend of the artery and hence another 3.5 x 8 Onyx drug-eluting stent was deployed in overlapping manner at 16 atmospheres and post-dilated at 14 atmospheres in the overlapping segment with excellent angiographic results without complications. The patient tolerated the procedure well.
325 mg of aspirin and 300 mg of additional Plavix was given on the day of the procedure post angioplasty. ACT was monitored throughout the case as needed. Heparin was given for anticoagulation.
Procedure was completed without complications.
CONCLUSIONS: Successful shock wave lithotripsy and angioplasty with stent deployment in the mid LAD using a 2.75 stent as well as a 3.5 stent in overlapping manner with excellent angiographic results without complications.
I couldn't find a specific CPT CODE for Coronary Shockwave Lithotripsy.
- Can we consider this as Atherectomy and code it as 92933 - LD ?
Or
- is this considered part of angioplasty and code as 92928 - LD Only?
TIA
Vid.
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