On Demand: 2026 PCI and LER Procedure Coding Recap: What's Changed, What Documentation Matters, and How to Correctly Code-Webinar Recording

Video Transcription

Video Summary

In this detailed educational webcast, Nicole Knight and Jolene Bruder from MedAxiom provide an in-depth review of PCI (Percutaneous Coronary Intervention) and lower extremity intervention procedural coding updates for 2024. They discuss key revisions including terminology changes in primary PCI codes, deletion of non-reimbursable branch codes, and the introduction of new codes for complex stenting (92930) and integrated retrograde CTO approaches (92945). Important clarifications were made around modifier usage, such as no longer needing modifier 52 for IFR procedures. Mechanical aspiration thrombectomy coding was also updated to separately recognize specific devices, distinguishing them from manual aspiration devices.<br /><br />They emphasize the necessity for thorough and precise documentation, including clear diagnosis coding, lesion descriptions, exact vessel and segment identification per the NCDR registry, and clinical indications—especially distinguishing emergent AMI interventions. For multi-lesion or multi-vessel cases, coders must follow established hierarchy rules to select appropriate base and add-on codes, avoiding duplicate billing for overlapping stents or contiguous lesions.<br /><br />Lower extremity intervention coding updates feature detailed distinctions by vascular territories—iliac, femoral/popliteal, tibial/peroneal, and newly recognized inframalleolar vessels—with corresponding RVU values. The AMA defined lesion types strictly as stenosis or 100% occlusion for complex coding. Lithotripsy codes and intravascular imaging codes were reviewed, as well as thrombectomy classifications and their billing.<br /><br />They provide case examples illustrating appropriate code assignment for complex PCI and lower extremity procedures, stressing accurate documentation supporting lesion distinctness, approach techniques, and successful intervention. The session concludes with reminders on ultrasound guidance, sedation coding, and ambulatory surgery center reimbursement considerations. Recorded Q&A highlighted ongoing clarifications and potential payer denials requiring attention. The overall focus is on aligning clinical documentation, coding, and billing practices with new CPT guidelines to ensure compliance and appropriate reimbursement.

Keywords

PCI coding updates 2024

Percutaneous Coronary Intervention

Lower extremity intervention coding

Primary PCI terminology changes

Non-reimbursable branch code deletion

Complex stenting code 92930

Retrograde CTO approach code 92945

Modifier usage clarifications

Mechanical aspiration thrombectomy coding

NCDR registry lesion documentation

Multi-lesion coding hierarchy

Vascular territory distinctions

Lithotripsy and intravascular imaging codes