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addtl vessel stenting coding issue

Annmarie Posted Mon 21st of July, 2014 11:07:47 AM

Please advise how to code & get reimbursed for additional stents placed.
Currently we are billing 92928 plus the vessel modifier(ie: ld,rc,lc)and if a stent is placed in another vessel we bill 92929 plus the vessel modifier and havent been sucessful getting reimbursement as we are told by medicare 92929 is a bundled code & will never pay. Please advise the correct code that should be used for stenting additional vessels.
Thank you.

SuperCoder Answered Tue 22nd of July, 2014 06:18:50 AM

CMS has decided to give the add-on codes for stent placement in additional vessel a "bundled" status on the Medicare Physician Fee Schedule. They will only pay for the "base" codes and aren't paying for the additional branches. What they did is bundled the payment for the add-on codes in the main code, increasing the fee slightly for each main code.

They have taken this stance because of the concerned raised that more granular coding may increase placement of stents.

Thanks !!

Annmarie Posted Wed 23rd of July, 2014 09:42:41 AM

thank you

SuperCoder Answered Wed 23rd of July, 2014 10:17:54 AM

You are welcome.

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