Health Information Management

Coding cardiac vs. peripheral stent placement

APCs Insider, October 16, 2003

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THE MONITOR'S ADVISORY BOARD

Keith Siddel
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HRM, Hospital Resource Management

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Health Revenue Assurance Associates

Cheryl D'Amato
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Julie Downey
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University Colorado Hospital

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Today's question covers coding of cardiac versus peripheral or non-cardiac stent placements. Read on to learn the difference.



Your APCs Weekly Monitor is a free weekly e-zine from HCPro, publisher of Briefings on APCs, the monthly newsletter devoted entirely to managing under APCs, and the newsletter, APC Answer Letter, with answers to readers' questions about coding for APCs.

The Monitor is a complimentary companion publication with a specific mission: to provide answers to your tough questions about the APC regulations.

If you have a question about APC coding that you would like addressed in the Monitor, post it on our Web site at himinfo.com. Each week, our team of experts answers a question that will appeal to the majority of readers. The elected question and the corresponding answer are delivered to your inbox every Friday.


TODAY'S TOPIC: Cardiac vs. peripheral stent placement

QUESTION: Is there a difference between coding cardiac stent placements and peripheral or non-cardiac stent placements?

ANSWER: Yes. Both the right and/or left heart catheterizations as well as cardiac angioplasty are included in the cardiac stent placement and are not coded separately if done on the same vessel. Consequently, the only code billed is the 92980 or 92981. If the physician performs an angioplasty on another vessel, you are allowed to code the angioplasty. See CPT Assistant December 1996, page 11, for guidance on coding these procedures.

For the peripheral, or non-cardiac stent placement, codes are assigned for all procedures performed when done alone or in conjunction with a cardiac stent placement. Most angiography codes are in the 36000-36248 range. The angioplasty codes are in the 35450-35476 range, and the peripheral stent placement codes are in the 37205-37208 range. Refer to CPT Assistant April 2001, page 10, or the Society of Interventional Radiology Handbook for further guidance.


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Questions from readers are answered by a team of experts working in the APC area within the health care industry. Their answers are provided as advice. Readers should consult the federal regulations governing OPPS, related CMS sources, and with their local fiscal intermediary before making any decisions regarding the application of OPPS to their particular situations.


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