Question:

How is the following scenario coded? A patient has an SVG anastomosed to the LC obtuse marginal (OM). Next, this graft “jumps” to the RC posterolateral branch. Through the vein graft, the OM lesion is treated with angioplasty and bare metal stenting and a second lesion in the posterolateral branch of the RC is treated with angioplasty and bare metal stenting.

Answer:

Assign code 92937 to describe angioplasty and bare metal stenting of the OM lesion through the graft and assign 92938 for the angioplasty and bare metal stenting within the RCA. Even though the procedure was performed through one vein graft ostium and blockages in two major coronary arteries were dilated, the vein graft is analogous to a single major coronary artery and each artery is coded separately. The OM and RCA are “branches.” To delineate the vessels for the payer, add HCPCS modifiers LC and RC to each CPT® code.

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