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Coronary Intervention to LAD, immediate after developed Stent thrombosis

Oscar Posted Fri 10th of July, 2015 09:21:51 AM

Please answer the following coding scenario:
My doctor initially has performed Stents placement in Proximal, Mid and Distal LAD for 80% lesions in each area. This intervention is successful with TIMI 3 flow with no chest pain. Then patient shifted on to Stretcher to move to recovery room. Suddenly he complained again with chest pain, nausea and vomiting. Then shifted back on to cath table and did an Angiogram of Left system, showing complete blockage of LAD with ST Elevations. Then my doctor did PTCA with Thrombectomy help. Then recovered TIMI 1 flow with no chest pain again. But, decided to send him for Bypass surgery. In this situation I am coding....

92928-LD (For Initial Stents)
93454 (For repeat angiogram)
92941-LD,76 (For Angioplasty again)
92973 (Thrombectomy, because used V3 Thrombectomy catheter)

Please suggest Am I correct? if not please suggest the correct coding.

SuperCoder Answered Mon 13th of July, 2015 03:44:33 AM

Well, procedure coding seems appropriate, but need to add some modifiers. CPT code 93454 is a column 2 code for 92941, use modifier 59 with code 93454. And with CPT 92941, modifier 78 is more appropriate. Hope it helps!

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