Cardiology Coding Alert

Question:  I'm reporting a right iliofemoral vein puncture for right heart catheterization with thermodilution and Fick cardiac output measurements, saturation run, performed at a hospital. Should I report the puncture plus 93451, 93503, 93561, and 93562?Codify MemberAnswer: For the services you describe, you should report only 93451 (Right heart catheterization including measurement[s] of oxygen saturation and cardiac output, when performed). You should append modifier 26 (Professional component) to indicate you're reporting only the physician's services. The hospital will claim the technical component.Rationale: New-for-2011 code 93451 states that it represents right heart catheterization, and if the physician measures oxygen saturation or cardiac output, those services are included in the code, too.CPT® guidelines tell you that cardiac catheterization "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."The guidelines go on to instruct that 93451 includes [...]