Cardiology Question for the Week of June 20, 2016

Question:

A left heart catheterization (LHC) was performed on a Medicare patient, then a drug-eluting stent (DES) was placed in the left anterior descending artery (LAD), and an angioplasty of the diagonal branch was performed. What can the hospital charge here?

Answer:

If a diagnostic LHC with coronary angiography is performed with DES in the LAD and percutaneous transluminal coronary angioplasty (PTCA) in a diagonal, the following are the codes to assign. Be sure to append modifier -59 to code 93458. Since the diagonal is a branch of the LAD, you report an “additional branch” code.

For the LHC:

93458

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed

For the DES to the LAD:

C9600

Percutaneous transcatheter placement of drug eluting intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch

For the PTCA of the diagonal branch:

92921

Percutaneous transluminal coronary angioplasty; each additional branch of a major coronary artery (List separately in addition to code for primary procedure)

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.