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    Coding Cardiac Catheterizations

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    A cardiac catheterization is a diagnostic procedure where a catheter is inserted into the heart to examine heart function and detect any issues. The document discusses how cardiac catheterizations are coded, noting they were previously coded with three separate codes but are now bundled into a single code. It provides a chart showing the codes for right and left heart catheterizations, as well as add-on codes for things like injections or stress tests. Congenital cases continue to be coded separately. The document concludes by answering questions on coding two patient cases involving stents and other cardiac procedures performed during catheterizations.

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    Coding Cardiac Catheterizations

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    api-270110430
    198 views4 pages
    A cardiac catheterization is a diagnostic procedure where a catheter is inserted into the heart to examine heart function and detect any issues. The document discusses how cardiac catheterizations are coded, noting they were previously coded with three separate codes but are now bundled into a single code. It provides a chart showing the codes for right and left heart catheterizations, as well as add-on codes for things like injections or stress tests. Congenital cases continue to be coded separately. The document concludes by answering questions on coding two patient cases involving stents and other cardiac procedures performed during catheterizations.

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    A cardiac catheterization is a diagnostic procedure where a catheter is inserted into the heart to examine heart function and detect any issues. The document discusses how cardiac catheterizations are coded, noting they were previously coded with three separate codes but are now bundled into a single code. It provides a chart showing the codes for right and left heart catheterizations, as well as add-on codes for things like injections or stress tests. Congenital cases continue to be coded separately. The document concludes by answering questions on coding two patient cases involving stents and other cardiac procedures performed during catheterizations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    198 views4 pages

    Coding Cardiac Catheterizations

    Uploaded by

    api-270110430
    A cardiac catheterization is a diagnostic procedure where a catheter is inserted into the heart to examine heart function and detect any issues. The document discusses how cardiac catheterizations are coded, noting they were previously coded with three separate codes but are now bundled into a single code. It provides a chart showing the codes for right and left heart catheterizations, as well as add-on codes for things like injections or stress tests. Congenital cases continue to be coded separately. The document concludes by answering questions on coding two patient cases involving stents and other cardiac procedures performed during catheterizations.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 4

    Coding Cardiac Catheterizations

    First of all what is it? It is a diagnostic procedure. Here are a few


    great YouTube videos
    1 http://youtu.be/kY5gKdFWT3k
    2 http://youtu.be/sXrO52vqUQI
    Prior to 2011 you needed three pieces to code a cardiac cath
    1 catheterization code
    2 injection (of dye) code - 1 or more
    3 imaging code - 1 or more
    Now we have things packaged up differently.
    What you need to abstract:
    1 congenital or not
    2 which side of heart - right, left or both
    3 any add on procedures
    Being the visual learner I am I had to put this in a chart. Your
    2013 CPT Manual includes a chart as well starting on page 516.
    However I like looking at it based on which side of the heart is
    being catheterized and narrowing it down from there.
    For non-congenital things are bundled so one code represents the
    catheterization, the injection and the imaging.

    By Laureen Jandroep, CPC, CPC-I, CMSCS, CHCI ~ Instructor (888) 226-5799


    www.CodingCertification.org HelpDesk@CodingCertification.org

    Location

    Code

    Includes

    Right Heart Catheterization


    Default 93456

    injections + imaging

    With Bypass Grafts 93457

    injections + imaging

    Right Only - no coronary arteries 93451


    Left Heart Catheterization
    Default 93458

    injections + imaging

    With Bypass Grafts 93459

    injections + imaging

    Left Ventricle Only 93452

    injections + imaging

    Left & Right Catheterizations


    Default 93460

    injections + imaging

    With Bypass Grafts 93461

    injections + imaging

    Left Ventricle Only 93453

    injections + imaging

    Native Only 93454

    injections + imaging

    Native + Bypass 93455

    injections + imaging

    Vessels Only

    Injection Add On Codes


    for selective right ventricular or right atrial 93566
    angiography

    *only report one of these injection


    add on codes per case

    for supravalvular aortography 93567


    for pulmonary angiography 93568
    Other Add On Codes
    via a transseptal route 93462
    Pharmacologic agent administration 93463
    Physiologic exercise study 93464

    By Laureen Jandroep, CPC, CPC-I, CMSCS, CHCI ~ Instructor (888) 226-5799


    www.CodingCertification.org HelpDesk@CodingCertification.org

    If congenital then you are going to have one code for the
    catheterization (93530-93533) and contrast injection(s) are
    coded separately with 93563-93568.
    If diagnostic angiography is performed during the same session as
    therapeutic intervention, append the -59 modifier to the S&I codes.
    S&I codes are not used to report post intervention injections in the
    coronary vessels to determine level of effectiveness. These
    injections and S&I are included in the valuation of the intervention
    codes and not reported separately.
    (AMA CPT Changes 2011: An Insiders View)

    I covered cardiovascular stents and other therapeutic


    interventions twice before. Here are links to those video clips:
    1

    CPT Stents and Cardiac Cath Coding Tips- Bubble and Highlighting ...

    Medical Coding Help- Cardiovascular Stents

    So now for the questions:


    patient #1- Dr. did 93459 and stent/ivus/lad, and descending
    aortogram
    patient #2 Dr. did 93459- stent/ivus/ffr/lad
    Definitions:
    1 93459 - see table above - left heart cath...

    By Laureen Jandroep, CPC, CPC-I, CMSCS, CHCI ~ Instructor (888) 226-5799


    www.CodingCertification.org HelpDesk@CodingCertification.org

    2 LAD = left anterior descending (coronary) artery.


    3 IVUS = intravascular ultrasound (allows us to see a coronary
    artery from the inside-out.)
    a Great explanation at Angioplasty.Org
    b 92978 - Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation and/or
    therapeutic intervention including imaging supervision, interpretation and report; initial vessel
    (List separately in addition to code for primary procedure)

    4 Stent = 92980 - Transcatheter placement of an intracoronary stent(s), percutaneous, with or


    without other therapeutic intervention, any method; single vessel

    5 descending aortogram - I would need to see report but I


    suspect this is more to evaluate the access site and is
    therefore bundled.
    6 FFR - fractional flow reserve (from 2nd question)
    a 93571-26 for initial vessel and 93572-26 for additional

    vessel

    By Laureen Jandroep, CPC, CPC-I, CMSCS, CHCI ~ Instructor (888) 226-5799


    www.CodingCertification.org HelpDesk@CodingCertification.org

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