Left radial artery anigraphy..

[daniel]

My main question is how do you code for the radial approach. The stent procedure I understand how to code.

Procedure Title
1) Left radial artery angiography
2) Selective coronary angiography of left internal mamary artery graft to left anterior desecnding artery.
3) Percutaneous transluminal coronary angioplasty and deployment of a 2,25 x 13mm cypher drug-eluting stent into left anterior descending artery through the left internal mammary artery graft via left radial approah.
4) Adminsitration intravenous angiomax
5) Radiological supervision and interpretation



Procedure Detail:

The left radial area was prepped and drapped in sterile manner. using 1% Xylocaine anesthetic and using micropuncture needle, the left radial artery was accesses without any difficulty, over which a 6-french sheath was inserted. A left radial artery angiogram was performed. A terumo guidewire was then advance over which a 6 french-LIMA guiding catherter was advanced and postioned in the ostium of the left internal mamamary artery. Left internal mammary angiogram was performed. The site of the lesion was identified. A BMW guidewire was passed over the which a 2 x 12 mm balloon was advanced. The balloon was used to pre-dilate the lesion quite good. There was no eveidence of residual stenosis or dissection. Distal flow was TIMI 3. Satisfied with the results, right coronary angiogrma was preformed. Hemostatic wrist band was applied. The patient tolerted the entire procedure well.


This is my selectin

CPT 93455.26
CPT 92980. LD


Thanks
Daniel,CPC

[RSammons]

This would be coded the same as if it were femoral artery approach--nothing different due to radial access. As far as the radial angiogram, unless you have medical necessity & findings, I would consider this to be part of the procedure--guiding the access. Hope this is helpful.

[dimmitta]

I agree with RSammons, there would not be a separate procedure billed for the radial access unless there was clear medical necessity. This would be billed same as heart cath from femoral access.

[daniel]

Thanks to both of you.


Daniel,CPC