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ptca/stent plus filter wire

  1. Default ptca/stent plus filter wire
    Medical Coding Books
    can I bill for more than the 92980 RC (additional stenting ?) can I bill for the filter wire (code?) Thanks

    PROCEDURE:
    PTCA/stent of the saphenous vein graft to the right coronary artery plus
    FilterWire plus a femoral angiogram.
    After doing a cardiac catheterization, under sterile condition, after
    informed consent, multiple stents were used and saphenous vein graft to
    the right coronary artery was cannulized. FilterWire was passed across
    the lesion and deployed. A 3.5 x 23 mm Xience drug-eluting stent was used
    and placed at the site of the narrowing. It was post-dilated with 4.0 x
    12 mm NC Voyager balloon. After this, the FilterWire was retrieved.
    Guiding shots were taken. There were good angiograph results, lesion
    greater than 90% to almost 0%.
    During the procedure, IV Integrilin and IV Angiomax was used.
    The patient will be given 300 mg of Plavix.
    Femoral angiogram, contrast was injected through the sheath to evaluate
    the femoral artery. There was no evidence of any dissection.
    IMPRESSION:
    Successful PTCA/stent of the saphenous vein graft to the right coronary
    artery lesion, greater than 90%, improved to almost 0% to 10%.

  2. #2
    Location
    Birmingham, Alabama
    Posts
    890
    Default
    Quote Originally Posted by Theresa Hartlage View Post
    can I bill for more than the 92980 RC (additional stenting ?) can I bill for the filter wire (code?) Thanks

    PROCEDURE:
    PTCA/stent of the saphenous vein graft to the right coronary artery plus
    FilterWire plus a femoral angiogram.
    After doing a cardiac catheterization, under sterile condition, after
    informed consent, multiple stents were used and saphenous vein graft to
    the right coronary artery was cannulized. FilterWire was passed across
    the lesion and deployed. A 3.5 x 23 mm Xience drug-eluting stent was used
    and placed at the site of the narrowing. It was post-dilated with 4.0 x
    12 mm NC Voyager balloon. After this, the FilterWire was retrieved.
    Guiding shots were taken. There were good angiograph results, lesion
    greater than 90% to almost 0%.
    During the procedure, IV Integrilin and IV Angiomax was used.
    The patient will be given 300 mg of Plavix.
    Femoral angiogram, contrast was injected through the sheath to evaluate
    the femoral artery. There was no evidence of any dissection.
    IMPRESSION:
    Successful PTCA/stent of the saphenous vein graft to the right coronary
    artery lesion, greater than 90%, improved to almost 0% to 10%.
    As for the procedure codes, there is no additional code for the filterwire. You should be able to bill for the facility (supplies) but I do not know the code.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  3. Default Ptca
    Would the procedure code 92980 would be the only code to bill when a PTCA and stenting of saphenous vein graft to obtuse marginal with filterwire was done on a patient?

  4. Default
    No actually I believe you can and should bill for the filter wire placed during stenting of the vein graft.

  5. Question
    I guess I should have added Medlearn was asked this question and here is their response july 2010.

    Question:
    Is there a code for placement of distal embolic protection device prior to an angio procedure that does not specifically have it listed in the procedure description?


    Answer:
    It depends upon the procedure that will use the embolic protection device. For example, some payers may accept 37799 for peripheral procedure although no code exists. There also is no code for coronary, but some payers may accept 93799.

    Also I have read on the boston sciencific website that ACC recommends using these unlisted codes.

    I am interested to know if anyone has had any luck with this.

  6. #6
    Default
    Quote Originally Posted by theresa.dix@ethc.com View Post
    I guess I should have added Medlearn was asked this question and here is their response july 2010.

    Question:
    Is there a code for placement of distal embolic protection device prior to an angio procedure that does not specifically have it listed in the procedure description?


    Answer:
    It depends upon the procedure that will use the embolic protection device. For example, some payers may accept 37799 for peripheral procedure although no code exists. There also is no code for coronary, but some payers may accept 93799.

    Also I have read on the boston sciencific website that ACC recommends using these unlisted codes.

    I am interested to know if anyone has had any luck with this.
    Also recommended by Dr. Z in his book.
    Jim Pawloski, CIRCC

  7. #7
    Location
    Phoenix, AZ
    Posts
    620
    Default
    Theresa,

    I looked at the Medlearn for July of 2010. I can't find the Q&A you have on this. Our management wants to see the actual update. Would you send a link or fax (email) a copy to me? I would SO appreciate that. I need to get the 93799 code into our fee schedule.

    Thanks!
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

  8. #8
    Location
    Phoenix, AZ
    Posts
    620
    Default
    Okay, so I've been billing 93799 for embolic protection and today found in Dr Z's book that he recommends not to bill for distal embolic protection because it is bundled. This is from his 2010 book. If anyone has an updated book with a reversal on this recommendation, please let me know with references.

    Thanks,
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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