Q & A with Dr. David Zielske

Question     
Four coronary Artery stents
1st lesion intervention: A successful stent with balloon angioplasty was performed on the 90% lesion in the 1st obtuse marginal. 2nd intervention: A successful stent with balloon angioplasty was performed on the 99% lesion in the 2nd obtuse marginal. 3rd intervention: A successful stent with balloon angioplasty was performed on the 90% lesion in the right posterior descending artery. 4th intervention: A successful stent with balloon angioplasty was performed on the 90% lesion in the mid right coronary artery. I am coding 92928-RC, 92929-RC(right posterior descending), 92929-LC (1st obtuse). Can you code for the 2nd obtuse (92929-LC)? Per CPT: Additional percutaneous coronary intervention (PCI) in a third branch of the same major coronary artery is not separately reportable. Since there are two PCI in one branch and one PCI in another, could you use 92929 three times? I understand that Medicare considers the add-on code bundled into the base code.
 
Answer
We recommend 92928RC for right coronary artery, 92929RC for posterior descending artery, 92928LC for 1st obtuse marginal, and 92929LC for 2nd obtuse marginal.  Code 92928 can be used for a stent in the major coronary artery (left circumflex) or branch (1st obtuse marginal in this case).


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