Hello - Regarding the last post, I checked with a veteran cardiology coder, and here are the responses we came up with.
1. As per my understanding based on above answer "If there is a repositioning of Catheter for aortogram during cardiac cath (93454-93461)" then only can we bill Cath & 93567 together. If no repositioning occurs for aortogram during heart cath we cannot bill 93567, is this correct?
Response: Based on the CPT Changes reference in the previous post, repositioning and contrast injection(s) are needed to report 93567.
2. Also, if no repositioning of catheter has occurred during heart cath, but the physician extended the table through the ascending & abdominal aorta, can we bill 75600 or 75605 or 75625 or 75630 depending on service appropriateness? Because for all these radiological codes the Injection procedure code is 93567, and we are billing for "professional component only" please suggest.
Response: With positioning of a catheter and contrast being necessary, the extending of the table alone will not suffice. Angiography of a specific area is required and the physician must document the indication for performing procedures as well as the findings in the medical record. It is rare but can be done to provide an abdominal aortogram (75625) or abdominal aortogram with runoff (75630) during a heart catheterization procedure. If CPT codes 75625 or 75630 are provided, make sure the indication to perform this additional service meets medical necessity and criteria before choosing CPT codes 75625 or 75630 during a heart catheterization procedure (with mod 26 for professional component only). Numerous parties have identified that CPT codes 75625 and 75630 have been charged incorrectly during a heart catheterization procedure.
3. Would you please guide the best usage/scenario of 75625 or 75605 with 93567. Here, I would like to provide the scenario/service type which my doctor is performing to better clarity.
1) Scenario/Service Type1: Doctor performed the heart cath (93458) & abdominal aortogram during heart cath only. No catheter repositioning has occurred, the physician just extended the table through the abdominal aorta. No radiologist intervention is involved in the abdominal aortogram. My physician finishes the whole procedure. I have to bill professional component only for my physician. What CPT Codes should I use?
Response: 93458-26 describes the service.
2) Scenario/Service Type 2: Doctor performed the heart cath (93458) & abdominal aortogram during heart cath only. Catheter repositioning has occurred, and the physician extended the table through abdominal aorta. No radiologist intervention is involved in the abdominal aortogram. My physician finishes the whole procedure. I have to bill professional component only for my physician. What CPT Codes should I use?
Response: As long as the indication to perform this additional service meets the medical necessity and related criteria you could code 93458-26 and either 75625-26-59 or +93567 (check documentation for location and purpose). If an abdominal aortogram was provided for AAA (abdominal aortic aneurysm) it would be appropriate to code CPT 75625-26-59. If an aortogram was provided to view aortic insufficiency and the aortic valve you should code CPT +93567.