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mmarcum

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I have a case where the patient was admitted to the hospital with chest pain and then underwent heart cath where a stent was placed in the OM2. Patient had some neck and arm pain as he was taken off the table in the cath lab, but was returned to his room in stable condition. Patient was still having discomfort 30 minutes after the procedure so an EKG was performed and it indicated an acute inferior MI. Patient was taken emergently back to the cath lab where another stent was placed in the just distal to the first after the original stent had a balloon inflated in it twice. My question is since the second stent was placed in the same main artery as the first, can I bill for the placement of the second stent since it was performed in a session separate from the first?

Any ideas or input as to where I can find guidelines for billing this would be appreciated. Thanks.
 

deeva456

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I dont recall having seen this done before. However, since the doctor had to repeat the procedure and it was done the same day, different encounter I would bill 92980-5976 with the appropriate dx for the MI. You are indicating it is a different encounter and repeated procedure by the same MD. You will definitely get a denial but worth doing an appeal.

Good luck with this one!

Dolores, CPC, CCC
 
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