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Bundle and additional procedure done, 92928 and 92929

Carl Posted Wed 27th of January, 2016 02:37:09 AM

Dx: I24.0 Acute coronary thrombosis not resulting in myocardial infarction

The patient has recurrent chest pain, probable angina and dynamic EKG changes suggestive of myocardial ischemia.
He underwent (2015/11) selective coronary angiography. No prior angiographic study done.
Decision was made during the procedure to proceed with two vessel coronary angioplasty with 2 drug eluting stents in Circumflex (1 stent in the Cx and 1 stent in the Obtuse Marginal) and two stents in the LAD. Left radial vascular access.

CPT: 92928-LC, +92929, 92928-LAD, 93454

In the coding correct?
Any additional modifiers to add?
Can the diagnostic 93454 be unbundled from the other intervention codes?
If it can be unbundled, which terminology should be used in the text of the procedure to validate it?

SuperCoder Answered Thu 28th of January, 2016 02:45:43 AM

As per documentation, we can bill 93454 with modifier 59 to rule out bundling. For further clarity see article 17 in the below pasted link.

https://www.aapc.com/blog/23305-changes-plus-more-changes-for-cardiology-in-2013/

Carl Posted Mon 01st of February, 2016 02:33:47 AM

Is this sequence of CPT codes correct?
93458-59, 92928-RI
or the modifier 59 be associated with 92928 instead?
Thanks

Carl Posted Mon 01st of February, 2016 02:39:59 AM

Sorry, the above question was addressed to a different discussion topic.
The question for this item is:
Is this the right CPT code sequence for this procedure?
92928-LC, +92929-LC, 92928-LD, 93454-59
Thanks

SuperCoder Answered Tue 02nd of February, 2016 01:39:20 AM

Yes, 92928-LC, +92929-LC, 92928-LAD, 93454-59 is the correct code sequence.
It is correct to code procedures performed in second branch of a major coronary artery.
But never report additional procedures performed in a third branch of a major coronary artery. Thank you.

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