Cardiology Coding Alert

Question: How should I code a combined right heart catheterization (RHC) and left heart catheterization (LHC), as well as a sizing measurement (through intra-cardiac echo) of a PFO (patent foramen ovale)? I can't use 93662 because the physician did not perform a PFO closure. The PFO procedure is scheduled for two weeks from now because the patient has diastolic heart failure (acute on chronic) (428.33).

Texas Subscriber

Answer: CPT defines +93662 as "Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (list separately in addition to code for primary procedure)." The fact that the physician did not perform the PFO closure during the heart cath does not preclude you from using this code. You can report 93662 with diagnostic or therapeutic heart catheterizations. This code, in addition to the code for combined right and left heart cath (93526 or other code if performed by a different approach), should round out your coding for this procedure.

 - Answers to You Be the Coder and Reader Questions provided Jim Collins, CHCC, CPC, president of Compliant MD Inc. and compliance manager for several cardiology groups around the country; Cheryl Klarkowski, RHIT, a cardiology coding specialist with Baycare Health System of Green Bay, Wis; Happiness Miller, RN, an auditor with the cardiac catheterization lab in Central Baptist Hospital in Lexington, Ky; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.