Wiki CTO attempt

[drsmith1999@gmail.com]

Prox RCA to Mid RCA lesion is 100% stenosed. Given the large amount of myocardium supplied by the right coronary artery attempts were made to recannulized the vessel. It was probed with a BMW wire to see if it was a recent occlusion, however, it behaves like a chronic total occlusion. The BMW wire did make progress as though a successful recannulization might occur of the chronic total occlusion. The BMW did not have enough body therefore a miracle Brothers wire was utilized. This progressed down a slightly different path and eventually followed the course of the vessel. And over the wire balloon was advanced and injection through the balloon showed this to be in a subintimal track. It was not felt that additional attempts to open the right coronary artery in the setting of patient's clinical presentation were in his best interest.

Could this be billed with 92943 since there was some progress made or will it need modifier 53 for attempted CTO?

 

[arclayton]

Definitely add modifier 53. Wire/balloon was advanced, injections performed but no actual inflations.

 

[drsmith1999@gmail.com]

Definitely add modifier 53. Wire/balloon was advanced, injections performed but no actual inflations.

Thank you. I did bill it with modifier.