Cardiology Coding Alert

Question: How should I code a right heart catheterization with pulmonary vasoreactivity test?

Codify Member

Answer: For the right heart catheterization, you should report 93451 (Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed).

For pulmonary vasoreactivity, you should report add-on code +93463 (Pharmacologic agent administration [e.g., inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent] including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed [List separately in addition to code for primary procedure]).

The vasoreactivity test can help physicians identify which patients with pulmonary hypertension will benefit from long-term calcium channel blocker therapy.

Bonus tip: You may see a longer list of primary codes for +93463 in 2013. The CPT® Editorial Panel accepted a proposal to add 93580 (Percutaneous transcatheter closure of congenital interatrial communication [i.e., Fontan fenestration, atrial septal defect] with implant) and 93581 (Percutaneous transcatheter closure of a congenital ventricular septal defect with implant) to the list of codes you may report with +93463. The code changes won't be final until the fall, but you may review possible changes at www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/cpt-summary-panel-actions.page.