left heart cath

[mdunn]

What determines whether to bill 93454 or 93458. In the dictation the physician states "the aortic vavle was cross", but the ventriculogram was not performed. The nurses that enter the charges believe this is 93454 because there was no ventriculogram, but I feel it is still 93458(left heart cath) because the aortic valve was crossed. Code 93458 states "ventriculogram, when performed".

[sheri_hall2000@yahoo.com]

As long as pressures were done in the LV, you can bill 93458, even without the ventriculogram.

[Cyndi113]

93454 is coronary angiography. 93458 is coronary angiography and LHC.

[mdunn]

Seems as though everyone has totally answered everything but my actual question. I want to know if you still code 93458 if the ventriculogram is not performed, but the aortic valve is crossed. NO PRESSURES were measured, no ventriculogram.

[Jim Pawloski]

Originally Posted by mdunn

Seems as though everyone has totally answered everything but my actual question. I want to know if you still code 93458 if the ventriculogram is not performed, but the aortic valve is crossed. NO PRESSURES were measured, no ventriculogram.

If no LVgram performed or no pressures were taken, then no LHC. You have just an Coronary angiography.
HTH,
Jim Pawloski, CIRCC

[dpeoples]

Originally Posted by Jim Pawloski

If no LVgram performed or no pressures were taken, then no LHC. You have just an Coronary angiography.
HTH,
Jim Pawloski, CIRCC

I agree with Jim.

HTH

[Jim Pawloski]

Originally Posted by dpeoples

I agree with Jim.

HTH

Thanks Danny, good to hear from you!

Jim Pawloski,
CIRCC

[Misty Dawn]

Originally Posted by Jim Pawloski

If no LVgram performed or no pressures were taken, then no LHC. You have just an Coronary angiography.
HTH,
Jim Pawloski, CIRCC

I am confused. The left heart cath codes are defined as "with or without LVgram" but your are saying the LVgram must be performed to bill on Left HTC?

[jewlz0879]

Originally Posted by Jim Pawloski

If no LVgram performed or no pressures were taken, then no LHC. You have just an Coronary angiography.
HTH,
Jim Pawloski, CIRCC

Jim,

Thank you so very much for this clarification. When I first started Cardio coding I was told that, "as long as the physician crosses the aortic valve, you have a LHC." I'm glad to have been set straight.

[dpeoples]

Originally Posted by Misty Dawn

I am confused. The left heart cath codes are defined as "with or without LVgram" but your are saying the LVgram must be performed to bill on Left HTC?

Misty,
It is primarily the left ventricular pressures that must be documented. Certainly if a left ventriculogram is documented you have a LHC. It is when there is no left v'gram that the question arises. In the age of cut and paste or canned documentation, just stating the aortic valve was crossed is not enough IMO.

HTH