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

Webinar Slides

Pdf Summary

The document is a comprehensive overview and update on the 2026 procedure coding and documentation guidelines for Percutaneous Coronary Intervention (PCI) and Lower Extremity Revascularization (LER). Presented by Nicole Knight and Joline Bruder from MedAxiom Revenue Cycle Solutions, it outlines new CPT code changes, documentation requirements, reimbursement impacts, and coding tips for both coronary and peripheral vascular interventions.<br /><br />Key updates in PCI coding include revisions to primary and stent codes, introduction of new complex stent and Chronic Total Occlusion (CTO) codes (92930 and 92945), and deletion of branch codes used in prior years. Documentation must clearly support clinical indications, lesion specifics, lesion location including coronary artery and branches, bifurcation involvement, procedures performed, and outcomes. Definitions and terminology related to CTO techniques are clarified, emphasizing the importance of detailed antegrade and retrograde approach documentation to ensure proper code selection and avoid billing errors. The hierarchy of PCI codes is explained with emphasis on one base code per major artery intervention and use of appropriate modifiers.<br /><br />For LER procedures, new 2026 work RVUs and CPT codes are detailed across four vascular territories: iliac, femoral/popliteal, tibial/peroneal, and inframalleolar. Guidelines define straightforward versus complex lesions, lesion reporting across vessels and territories, and coding limits on add-on procedures. The document stresses careful documentation of lesion characteristics, access sites, embolic protection, and adjunct imaging or technologies like ultrasound guidance and intravascular ultrasound. Coding rules for diagnostic angiography and unsuccessful interventions are clarified, including modifier use for bilateral procedures.<br /><br />Case studies demonstrate application of these guidelines with real-world scenarios coding complex coronary PCI with overlapping stents, CTO interventions using combined antegrade and retrograde approaches, and LER procedures incorporating lithotripsy, stenting, and angioplasty. Each includes correct CPT coding, use of modifiers, and documentation best practices.<br /><br />Overall, the presentation serves as an essential resource for physicians, coders, and revenue cycle professionals to ensure accurate procedure coding, appropriate reimbursement, and compliance with updated Medicare and CPT regulations in 2026 for coronary and peripheral vascular interventions.

Keywords

Percutaneous Coronary Intervention

Lower Extremity Revascularization

2026 CPT Code Updates

Chronic Total Occlusion Codes

PCI Documentation Guidelines

LER Coding Tips

MedAxiom Revenue Cycle Solutions

Coronary and Peripheral Vascular Interventions

Modifier Usage in Coding

Reimbursement and Compliance