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LM vs LAD stenting question

  1. Default LM vs LAD stenting question
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    When billing PCI, we bill one stent for each of the 3 major vessels: LAD., LC and RCA. Our doc insists that we should be able to bill a stent in the LAD and LM when done at the same session. Per Guidelines, I believe we cannot do this. Could someone give me additional info on this situation??? Just need to know if I am right or wrong. thanks

  2. #2
    I would just refer him to the NCCI Manual, Chapter XI, for CPT Codes 90000-99999, under Cardiovascular section, where it says:
    "Percutaneous coronary artery interventions include stent placement, atherectomy, and balloon angioplasty. For reimbursement purposes, Medicare recongnizes three coronary arteries: right coronary artery (modifier RC), left circumflex (modifier LC)and left anterior descending coronary artery (modifier LD). For a given coronary artery and its branches, the physician should report only one intervention, the most complex, regardless of the number of stent placements, atherectomies, or balloon angioplasties performed in that coronary artery and its branches."

  3. Default A big thanks
    Thank you so much. I appreciate some back up on this. Docs have their own way of thinking as i am sure you understand...

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