Sorry, its going to count as one cath session. In other words the patient was not stable and never left the cath room. Stabilizing the patient is expected part of post-procedure work. Dictate one cath report and bill one cath session. Since he put all the stents on the RC he can only code one 92980-RC.
He can try billing with a mod -22 due to the circumstances of having to re-inserting the catheter, the multiple stents etc. And CMS requires an additional separate letter. The documentattion will have to be very specific to show the extra time and work involved in the re-cath and stenting. Of course the payer may still not pay anything extra
If he did a 2nd diagnostic coronary angiography (93508) to identify the cause of the chest pain, be sure it is documented and coded with 786.50. And you will have to use the modifiers either for repeat procedure and the -59
To get this paid, you are going to have to submit the cath report.
Here is what I am thinking for the coding (just an example)
DX for all 414.01
The payers like to deny 93508 when coded with 92980. But a diagnositic angio is always separately payable from the interventional PTCA/stent. It is only inclusive if the vessel lesion is known (ie diagnostic done earlier or at a different cath lab) and the angio is only done in order to place the cath and do the PTCA/stent
See what other responses you get.
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