Billing 92928 (Percutaneous transcatheter placement of intracoronary stent) requires absolute anatomical precision. Failing to identify the exact coronary artery will result in an immediate denial.
The Required Coronary Modifiers
You must append the appropriate vessel modifier to 92928 to tell the payer exactly where the stent was placed:
- LC: Left circumflex coronary artery
- LD: Left anterior descending coronary artery
- RC: Right coronary artery
- LM: Left main coronary artery
Billing Additional Vessels
92928 covers the first stent in a single major coronary artery. If a stent is placed in a branch of that same artery, you bill the add-on code 92929. If a stent is placed in a completely different major artery (e.g., RC and LD), you bill 92928 for the first vessel, and 92928 with Modifier 59 (or XS) and the respective vessel modifier for the second.
NCCI Edits
Diagnostic heart catheterizations (93454-93461) can only be billed on the same day as a stent if they were truly diagnostic (no prior study existed, or the patient's condition suddenly worsened). If billed, append Modifier 59.