Cardiology Coding Alert

Question: Our cardiologist performed an endomyocardial biopsy in the course of left and right heart catheterizations. I have been told that the biopsy is no more than a right heart catheterization with removal of a tissue sample. Which codes should I use?
                      
Montana Subscriber  
Answer: In an endomyocardial biopsy (93505), the cardiologist performs much the same tasks as described in 93501 (Right heart catheterization), which is why the procedures are bundled in the Correct Coding Initiative. Therefore, 93501 should not be reported if an endomyocardial biopsy is also billed. In this case, however, both right and left heart catheterizations were performed.
 
This procedure would normally be billed 93526 (Combined right heart catheterization and retrograde left heart catheterization), but because the endomyocardial biopsy already includes a right heart catheterization, the left heart catheterization should be reported separately using 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous).