The Ramus is a branch off the Left Main and lies between the LAD and LCX and not everyone has a Ramus. Instead of the Left Main splitting into 2 vessels (LD And LC) it splits into 3 vessles (LD, LC and Ramus). But the Ramus is considered a branch (and not a vessel)of the either the LD or the LC so the branch rules apply
So basically you are placing a stent on 1 vessel and another stent on a branch of a 2nd vessel with both coming off of the Left Main. Medicare has been pretty clear that they will only consider interventions on the 3 vessles identified by CPT, the LD, LC and RC.
So for codng, the Ramus can be coded as either a branch of the LD or the LC. So suggest coding
92980-LD (your LAD vessel)
92981-LC (the ramus branch of the LC)
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