Janice Posted Sun 26th of June, 2016 21:56:46 PM
he did a LHC and am i right in coding 93458,92928 LD, 75710-26
Due to the patient's ongoing symptoms and ST elevation in the lateral leads, the decision to proceed with percutaneous revascularization was made. A 6-French Cordis XBLAD 3.5 guide was used to engage the left main coronary artery. A 190-cm, 0.014 BMW guidewire was used to cross the existing proximal LAD stent and placed in the mid to distal LAD. A 0.014, 185-cm moderate support Prowater wire was used to cross the lesion in the ostium of the first diagonal and was placed distally. A 2.0-mm balloon was used to perform a balloon angioplasty of the ostium of the first diagonal. Following balloon angioplasty, a 2.5 x 12-mm Xience Alpine drug-eluting stent was positioned in the ostial and proximal first diagonal and deployed at 10 atmospheres. The stent balloon was then removed and a 2.5 x 12-mm noncompliant balloon was positioned in the distal portion of the stent and balloon angioplasty was performed at 12 atmospheres. The balloon was then used to perform a kissing balloon angioplasty of the proximal to mid LAD stent with a 3.0 x 15-mm balloon and the ostium of the first diagonal stent in a simultaneous fashion. After simultaneous balloon angioplasty, angiographic images were obtained, which demonstrated excellent angiographic results with 0% residual stenosis of the ostium of the first diagonal, with good creation of the carina with no dissection or perforation noted. There was TIMI 3 flow noted in the LAD, as well as the diagonal branch. Please note that during the procedure, intravenous heparin bolus infusion was given for systemic anticoagulation and the ACT was monitored and therapeutic. Also, an intravenous Integrilin double bolus infusion was given. The patient was also given 325 milligrams of aspirin and 180 milligrams of ticagrelor.
SuperCoder Answered Mon 27th of June, 2016 08:08:40 AM
According to the documentation, the code seems to be appropriate. However, Code 93458 is a column 2 code for 92928, so append modifier 59 with 93458. Also, Code 75710 is a column 2 code for 93458, hence append modifier 59 with 75710.