On Demand: An In Depth Case Review of PCI and LER Procedures-Webinar Recording

Video Transcription

Video Summary

The webcast provided an in-depth coding review of 2026 percutaneous coronary intervention (PCI) and lower extremity revascularization procedures, focusing on documentation requirements, code hierarchy, and real-world case examples. Jolene Bruder covered coronary procedures, including the new PCI codes, how to distinguish simple versus complex stenting, when to report one base code per vessel, and special situations such as graft interventions, CTOs, AMIs, bifurcating lesions, and IVUS. She emphasized that coding depends on detailed provider documentation, especially lesion location, vessel segmentation, occlusion status, and approach. Multiple cases illustrated common pitfalls, such as confusing overlapping stents with complex stents, incorrectly coding diagnostic caths after staged procedures, and when CTO or AMI codes override other PCI codes.<br /><br />Tammy Barron then reviewed the 2026 lower extremity revascularization updates. She explained the new territory-based structure for iliac, fem-pop, tibial/peroneal, and inframalleolar interventions, along with the related angioplasty, stent, atherectomy, and lithotripsy codes. She stressed the importance of identifying straightforward stenosis versus complex 100% occlusion, and clarified that unsuccessful attempts that do not successfully cross a lesion are now considered diagnostic rather than intervention. She also covered bilateral coding rules and modifier use.<br /><br />Both speakers presented detailed cases showing how to apply the guidelines, including imaging, IVUS, atherectomy, stenting, lithotripsy, and sedation coding. They also addressed questions about bifurcations, tibial lithotripsy, and drug-coated balloons, encouraging coders to work closely with providers and payers for correct documentation and reimbursement.

Keywords

2026 PCI coding

lower extremity revascularization

coronary intervention

documentation requirements

code hierarchy

stent coding

CTO procedures

AMI coding

IVUS

graft interventions

bifurcation lesions

territory-based coding

modifier use