Ask an Expert  The hotline to leaders in specialty coding advice.

About this Question

  • Posted by 23530, 2 years ago. There are 7 posts. The latest reply is from .
No tags yet.
  1. Dear supercoder

    Can we bill 93567 with heart catheterization codes 93451-93461. I am clear that, if there is an additional catheter placed in abdominal aorta we can bill heart cath & 93567 together. But, If there is no seperate catheter placed in aorta but the physician extended the table through ascending aorta, abdominal aorta during heart catheterization can we bill 93567 & 93451-93461 together. If yes, does a modifier 59 required or not.

    Also is there any other CPT code for ascending aorta angiogram other than 93567 during cardiac catheterization. please suggest.

    Thani

  2. As this doesn't look to be an "additional catheter" in abdominal aorta, I think, we can't code 93567 in addition to 93451-93461 in case if "physician extended the table through ascending aorta, abdominal aorta during heart catheterization.

    But, I am referring this to our Editor a better answer.

  3. Please refresh my memory, what is the proper G-code to place on Medicare claims for e-prescribing.

  4. The text below is answer from our Editor for Oscar's question:
    =========================================
    CPT Changes 2011: An Insider’s View (from the AMA, and therefore authoritative) offers a procedure description for 93567 that refers to “repositioning” the catheter.

    It states : “codes 93530-93533 or 93451-93461 include the work of passing the catheter into the aorta. The work of 93567 begins with repositioning of catheter for aortogram. The catheter is then attached to a power injector, with careful removal of any air from the tubing. The catheter is positioned to inject the area of interest. Fluoroscopic guidance is used to ensure proper positioning of the catheter. Power injection is then performed to fill the aorta. The power injector is disconnected from the catheter; the catheter is re-attached to the manifold. The patient’s arterial pressure, electrocardiogram, and oxygen saturation are constantly monitored throughout the procedure. Additional images obtained by coronary angiography are reviewed and are described in the report of the procedure. Additional monitoring related to contrast injection is necessary to detect and treat heart failure symptoms and/or contrast-induced nephropathy.”

    The rationale given for the new codes in CPT Changes 2011 states codes 93566-93568 are intended for use with 93530-93533 and 93451-93461.
    *
    by
    *
    Deborah Dorton, JD, MA, CPC, CHONC
    The Coding Institute/SuperCoder
    deborahd@codinginstitute.com
    http://www.SuperCoder.com

  5. eRx - G8553

  6. Thank you very much sanjit for your Answer:
    As per my understanding based on above answer "If there is a repositioning of Catheter for aortogram during cardiac cath (93454-93461)" then only we have to bill Cath & 93567 together. If there is no repositioning occurs for aortogram during heart cath we cannot bill 93567, is this correct? please clarify.
    Also, there is no repositioning of catheter has occured during heart cath, but the physician extended the table through the ascending & abdominal aorta, Can we bill 75600 or 75605 or 75625 or 75630 depends 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.
    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 occured, just the physician extended the table through abdominal aorta. No radiologist intervention is there in abdominal aortogram. My physician only finishes the whole procedure. I have to bill professional component only for my physician. What CPT Codes should I use.

    2) Scenario/Service Type1: Doctor performed the heart cath(93458) & abdominal aortogram during heart cath only. Catheter repositioning has occured, and the physician extended the table through abdominal aorta. No radiologist intervention is there in abdominal aortogram. My physician only finishes the whole procedure. I have to bill professional component only for my physician. What CPT Codes should I use.

    Thank you very much and have a good weekend

  7. 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.

RSS feed for this Question

To Post Your Question
Subscribe to SuperCoder Ask An Expert
Already a
SuperCoder Member