This time, Cpt 2011 brings major overhaul to cardiac catheterization coding. As a matter of fact, there are 19 deleted cardiac codes, 20 added cardiac cath codes and only eight cardiac cath codes that remain the same.
To start with, here we will focus on the rules that apply jointly to new left (Lhc) and right heart cath (Rhc) codes 93451-93453:
93451: Rhc together with measurement(s) of oxygen saturation and cardiac output, when performed 93452: Lhc, together with intraprocedural injection(s) for left ventriculography, imaging management and interpretation, when performed 93453: Combined Rhc and Lhc together with intraprocedural injection(s) for left ventriculography, imaging management and interpretation, when performed.
Remember: Some of the deleted cardiac cath codes are 93501 (Right heart catheterization), 93510 (Lhc...), and 93526 (Combined Rhc and retrograde left heart catheterization), which you may have used in reporting similar services last year. The entire list of deleted codes includes 93501, 93508-93529, and 93539-93556.
Taking a look at the overarching section guidelines
As you would anticipate with so many code changes, Cpt offers new 'Cardiac Catheterization' section guidelines to help you use the just-in codes the right way.
Families: Keep congenital case codes detach
Cpt segregates the cardiac cath codes into two families:
a) For congenital heart disease
b) Those for all other conditions
Codes 93451-93453 fall under the "all other" family, however do not miss that Cpt guidelines include them in the codes allowable for cases intelligent 'anomalous coronary arteries, patent foramen ovale, mitral valve prolapse, and bicuspid aortic valve'. What's more, there is no detach code for congenital Lhc.
What is included: Cath Introduction to Closure
According to Cpt section guidelines, a cardiac cath is a diagnostic curative course together with all of the following:
Introduction, positioning as well as any required repositioning of catheter(s) within the vascular system Recording intracardiac and/or intravascular pressure(s) Final assessment and record of the procedure
If you verify the codes in the manual, you will also find the symbol indicating the codes include known sedation when performed by the same physician.
Codes 93451-93453 also include the 'road mapping' angiography the cardiologist uses to place the catheters. This means you shouldn't code injections separately or the imaging management and record linked to the road mapping. But then you may record unlikeness injections and the management and record for imaging that has a detach course code.
In the end, Cpt guidelines speak that you shouldn't separately record placing the closure gadget at the way site. Also, you should not record any unlikeness injection required for placing the closure device.
Add-on codes: Capture detach injection
Cpt added discrete new add-on codes that you may record in expanding to complicated cardiac cath codes, together with 93451-93453.
First are discrete imaging/injection course codes:
Rv/Ra angiography: +93566 Aortography: +93567 - Pulmonary angiography: +93568
Cpt's 'Injection Procedures' guidelines show that the above codes don t include catheter introduction; but then they do include repositioning the catheter and using self-operating power injections. Also, you have Cpt's approval to record any compound of +93566, +93567, and +93568 with your cardiac cath code. For instance, if the cardiologist carries out and documents both aortography and pulmonary angiography, you may use both +93567 and +93568. You are not little to reporting just one code.
To add to it, if the cardiologist carries out angiography of noncoronary vessels "as a certain service," you should take a look at the Radiology and Vascular Injection Procedures sections to find the allowable codes.
More add-on codes: Capture Hemodynamic Response chance
If the cardiologist administers a pharmacologic agent or has the sick person rehearsal to value hemodynamic response, you may use the following apart from the cardiac cath codes:
Agent: +93463: Exercise: +93464
Use each code only once per cath procedure. Cpt guidelines show that the above codes are allowable when the cardiologist uses the pharmacologic agent or rehearsal with the specific guess of repeating hemodynamic measurements to compare hemodynamic response.
