Cardiology Coding Alert

Question: Can intravascular Doppler (93571) be an add-on procedure during left heart catheterization (93510), coronary angiogram (93545) and left ventriculogram (93543)? Does there have to be additional intervention for reimbursement, such as a stent (92980)?


Delaware Subscriber  
Answer: You can use add-on code +93571 (Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement [coronary vessel or graft] during coronary angiography including pharmacologically induced stress; initial vessel [list separately in addition to code for primary procedure]) with the diagnostic heart catheterization codes you listed, regardless of whether your cardiologist performs an intervention. This is because the flow reserve measurement is another form of intravascular assessment that will help the physician determine the best course of treatment (such as medical management, percutaneous intervention or coronary artery bypass graft [CABG]).

Beware: Some coders report that their internal scrubber kicks out such claims because it is looking for the primary procedure, specifically 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) or 93508 (Catheter placement in coronary artery[s], arterial coronary conduit[s]...). These are limitations of your internal software, not correct coding guidelines or edits. 

Make sure your physicians know to document and that your coders know to report these valuable add-on services.    You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.