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Modifier 52

Date: Jul 16, 2013

Question:

We have a case where a PTCA occurred in the RCA, and an attempt was made to stent the mid lesion (there were three lesions in the RCA), but "due to profound calcification and tortuosity, unable to cross the lesion site. There was TIMI-3 flow with good results and the procedure was aborted". Does this description qualify as the procedure being terminated at "the provider's discretion", as relates to the stenting? In other words, would you code the attempted stenting (92928) with modifier -52, or would you just report code 92920 for the PTCA? We are an OP hospital, in case I didn't mention it. The type of stent was not mentioned in the dictation.

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