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It is not appropriate to report imaging supervision and interpretation (S&I) services for therapeutic coronary artery procedures.
#Native vessel meaning code#
Note that if multiple stents were placed side by side in a single vessel, the stent code would be reported only once.Ĭodes 92973 (percutaneous transluminal coronary thrombectomy), 92974 (coronary brachytherapy), 92978, and 92979 (intravascular ultrasound) are add-on codes for reporting procedures performed in addition to coronary stenting, atherectomy, and angioplasty, and are not included in the therapeutic interventions. 92984-RC PTCA, each additional vessel, RCA.If PTCA is performed in the LAD artery and also in the RCA, and a stent is placed in the circumflex, the coding of the procedure would be: Note that there are three modifiers used to identify the three major coronary arteries: The only CPT code that would be used to report this service is 92980-LD. This means that when a stent is placed because of an abrupt closure of a vessel during PTCA, or as a scheduled event, the PTCA in that same vessel is not reported separately. Additional major-vessel interventions may be reported using the "each additional vessel" codes, including the appropriate coronary artery modifier.įor example, if PTCA is performed in the LAD artery and the vessel is subsequently stented, the PTCA is bundled into the stent placement code, which is the highest paying service. Therefore, stent placement, angioplasty, and/or atherectomy may not be paid on the same vessel. Only one interventional procedure code per session is applied to each of the three major coronary arteries. When multiple interventions are combined during a single session on multiple vessels, the most complex intervention is to be reported by using that intervention's "single vessel" code and additional interventions using the appropriate "each additional vessel" code. Generally, stent placement supersedes atherectomy, which supersedes angioplasty. This means that certain services supersede other services and the other services are not reported separately. The Medicare Correct Coding Initiative (CCI) defines a hierarchical schema in technical complexity that exists when multiple coronary interventions are performed in a single session.
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Anatomic variants should be reported as closely as possible to a corresponding major vessel and not separately coded. Interventions in the branch vessels are considered a part of the intervention in the major vessel and are not reported separately.
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Each additional major coronary artery treated is identified by using the "each additional vessel" code. If a single intervention is utilized in more than one of these three vessels, the first vessel is to be identified using the respective "single vessel" code. Any other therapeutic coronary artery procedures in different vessels are reported using the "each additional vessel" code for the same procedure, which is reimbursed significantly less than the initial vessel code. Only the most highly valued procedure would be reported with the initial vessel code in the first vessel. On January 1, 1995, the regulation was changed to the current method.