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

Webinar Slides

Pdf Summary

This document is a 2026 MedAxiom coding webinar covering documentation and coding guidance for PCI and lower-extremity revascularization (LER) procedures, with multiple case studies and answer keys.<br /><br />For PCI, it reviews 2026 CPT code updates, reimbursement changes, coronary segment anatomy, and the progressive hierarchy used to select the correct base PCI code. It explains that only one PCI base code may be reported per major artery and its branches, with modifiers used for vessel identification. Special focus is given to distinguishing complex stent coding (92930) from standard stenting (92928), and to chronic total occlusion (CTO) coding (92943 for antegrade and 92945 for combined antegrade/retrograde). The presentation emphasizes that CTOs must meet strict documentation criteria: no antegrade flow through the true lumen, with supporting angiographic/clinical evidence, and that terms like subtotal or near-total occlusion do not qualify. It also highlights the importance of documenting the exact CTO approach and avoiding vague technique labels.<br /><br />Several PCI case studies illustrate coding choices for multivessel stenting, bifurcation lesions, CTO interventions, IVUS, and moderate sedation. Examples show when overlapping stents still code as a single base PCI, when separate base codes are allowed for distinct vessels, and when adjunct imaging or sedation may be billed.<br /><br />The LER section summarizes 2026 work RVU values and coding structure for iliac, femoral/popliteal, tibial/peroneal, and inframalleolar territories. It explains lesion complexity, unilateral territory-based coding, included services, and when diagnostic angiography can be separately reported. It also clarifies that unsuccessful intervention attempts are coded as diagnostic procedures. Additional guidance addresses bilateral procedures and modifiers.<br /><br />Multiple LER case studies demonstrate coding for angioplasty, stenting, atherectomy, lithotripsy, IVUS, and moderate sedation across different arterial territories and access sites.

Keywords

PCI coding

LER coding

2026 CPT updates

coronary anatomy

CTO intervention

stent coding

bifurcation lesions

IVUS

moderate sedation

vascular revascularization