Q&A: Drug eluting vs. non-drug eluting stents

May 3, 2011

QUESTION: We are having a conflict billing drug-eluting and non-drug-eluting stents together for Medicare patients. When coding G0290 (transcatheter placement of a drug-eluting intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) and 92981 (transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; each additional vessel), even with modifiers, the billing scrubber is hitting an edit that says we cannot bill code 92981 without code 92980 (transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel). But when we add 92980, it hits an edit stating that we cannot bill codes G0290 and 92980 together.

Should we code G0290 and G0291 (transcatheter placement of a drug-eluting intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; each additional vessel), since the drug-eluting stent is most extensive of the two procedures coded? Please help.

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