Cardiology Coding Alert

Question: May I code left internal mammary artery (LIMA) and right internal mammary artery (RIMA) bypass graft injection procedures separately from a cardiac cath?

New Hampshire Subscriber

Answer: You can report both the injection procedure and the cardiac catheterization.

Here's how: For the RIMA and LIMA procedures, you should report 93539 (Injection procedure during cardiac catheterization; for selective opacification of arterial conduits [e.g., internal mammary], whether native or used for bypass) when the cardiologist views the internal mammary arteries during a heart catheterization.

You should report 93539 in addition to other separately reportable procedures performed at the same session, such as 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery, or femoral artery; percutaneous).

Note: You should report 93539 only once per encounter. CPT Assistant (November 2002) states, "The injection procedure during cardiac catheterization codes (93539-93545) should be reported in addition to the cardiac catheterization code(s), and each code in this series may be reported only one time per cardiac catheterization."