Cardiology Coding Alert

Question: Which CPT^® code should we report for cardiac catheterization with coronary injections, left ventriculography, and interpretations of the studies performed in a facility? Do we need to add modifiers?

South Carolina Subscriber

Answer: For the service, you would report 93458 (Catheter placement in coronary artery[s] for coronary angiography, including intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection[s] for left ventriculography, when performed).

According to CPT^®, this code "includes introduction, positioning and repositioning, when necessary, of catheter(s), within the vascular system, recording of intracardiac and/or intravascular pressure(s), and final evaluation and report of procedure."

Because the service took place in a facility, append modifier 26 (Professional component) to show you're reporting only the physician's work and not the technical component.

Caution: You should never report 93458 in conjunction with the following codes:

• 0408T, Insertion or replacement of permanent cardiac contractility modulation system, including contrac­tility evaluation when performed, and programming of sensing and therapeutic parameters; pulse generator with transvenous electrodes
• 0409T, ... pulse generator only
• 0410T, ... atrial electrode only
• 0411T, ... ventricular electrode only
• 0414T, Removal and replacement of permanent cardiac contractility modulation system pulse generator only 
• 0415T, Repositioning of previously implanted cardiac contractility modulation transvenous electrode, (atrial or ventricular lead).