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Prahlad Posted Fri 20th of December, 2019 00:39:58 AM
Left heart catheterization Selective right and left coronary angiogram Nonselective LIMA angiogram Selective vein graft to PDA angiogram Selective vein graft to angiogram Right heart catheterization..................PLS CODE
SuperCoder Answered Mon 23rd of December, 2019 04:38:42 AM

Thanks for your question.


These types of cardiac procedures cannot be coded without operative reports. Operative report is must for accurate coding. As per the provided limited documentation, you should refer below mentioned CPT® code for the performed procedures.


93461-(Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography)


In this procedure, provider performs right and left heart catheterization with coronary and bypass graft imaging to evaluate heart function.


The provider takes the steps needed to insert a catheter through a sheath into a blood vessel, such as femoral vein. She uses fluoroscopic guidance and contrast injections as needed throughout the procedure. She advances the catheter through the right heart chambers into the pulmonary artery, taking pressure measurements in the various structures. She uses a balloon tip to occlude, or block, the pulmonary artery and takes additional measurements, such as diastolic pressure, oxygen saturation, and Fick cardiac output.  She uses a needle, guidewire, sheath, and catheter under fluoroscopic guidance to access the arterial system and reach the ascending aorta. She uses a catheter attachment to measure aortic root pressure. She moves the catheter to a coronary artery ostium to evaluate pressure and waveform and obtains various images. She repeats the imaging procedure for other coronary ostia as indicated, using additional catheters. She then moves another catheter across the aortic valve into the left ventricle, measures pressures and performs power injection to evaluate systolic function and the mitral valve. In this service, the provider also performs coronary injections for the assessment of stenosis and coronary artery disease. Additional catheters are utilized to engage the vein and internal mammary artery grafts. The contrast medium is visualized through X–ray technique thereby generating angiogram images. She reviews all images to be sure no additional work is needed. She may image the access site to see if a closure device is needed. She removes all catheters and stops bleeding as required.


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