Wiki Intracoronary nitroglycerine during PCI procedures - unbundle rules??

[ljones88]

Hi all,

I understand that 93463 and any PCI (92920, 92921, 92928, 92929,etc) are bundled. Is there ever a situation in which it is separately reported? Just trying to understand when it can and cannot be billed with a PCI. Our doctors are dropping 93463 with the PCI.

For example: patient is admitted through the ER for unstable angina. No prior visits to this facility, no prior cardiac cath studies on file for this patient, first time our dr is treating the patient. Doctor performs a cardiac cath, and determines that the LC needs to be stented. During the procedure the physician administers nitroglycerine, ad places the stent.

 

[Jim Pawloski]

Hi all,

I understand that 93463 and any PCI (92920, 92921, 92928, 92929,etc) are bundled. Is there ever a situation in which it is separately reported? Just trying to understand when it can and cannot be billed with a PCI. Our doctors are dropping 93463 with the PCI.

For example: patient is admitted through the ER for unstable angina. No prior visits to this facility, no prior cardiac cath studies on file for this patient, first time our dr is treating the patient. Doctor performs a cardiac cath, and determines that the LC needs to be stented. During the procedure the physician administers nitroglycerine, ad places the stent.

Per Z-Health, Do not code for injections of medications made into the heart chambers or arteries during a heart catheterization. These are bundled, although individual drugs may be billed with appropriate J-codes as indicated. Usually, 93463 is bill with a RHC to evaluate right heart failure.
HTH,
Jim Pawloski, CIRCC