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Which Modifier for Bypass Graft?

Posted on 30. Apr, 2012 by in Coding Challenge

Question: When the cardiologist places a stent in a coronary bypass graft, which modifier should we use? For example, if the patient has a saphenous vein graft going from the aorta to the right coronary artery, should we use a modifier to identify the graft?

 Answer: Typical payer policies will instruct you to append modifier RC (Right coronary artery) for the case you describe.

Here’s why: When the cardiologist places a stent in a coronary graft, you should use an anatomic modifier just as you would if she placed the stent in a native coronary vessel. For many payers, you will find written policies instructing you to base the modifier you use for the graft on the vessel the blood flows into.

Modifiers: The modifiers in question are RC, LC (Left circumflex coronary artery), and LD (Left anterior descending coronary artery).

In your example, the graft attaches to the aorta...

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