Cardiology Coding Alert

Question: If I used 93510, 93543, 93545, 93555, and 93556 for a procedure in 2010, how should I code the same service in 2011?

Answer: Your final code choice will depend on the documentation for your specific case, but the most likely match based on the codes you list is 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).

Start here: If you look in the CPT 2011 manual for the codes you used in 2010, you'll find instructions to see 93451-93461 and to read the instructions for injection procedures. To determine the proper code for your case in 2011, look at the services described by the 2010 codes you listed.

LHC: Code 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous) was for left heart catheterization (LHC). So the code you choose in 2011 needs to include LHC.

Imaging and injection procedures: Codes 93543 (Injection procedure during cardiac catheterization; for selective left ventricular or left atrial angiography) and 93545 (... for selective coronary angiography [injection of radiopaque material may be by hand]) were for left chamber and coronary imaging injection procedures.

Codes 93555 (Imaging supervision, interpretation and report for injection procedure[s] during cardiac catheterization; ventricular and or atrial angiography) and 93556 (... pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]) represented the S&I portion of the heart and coronary imaging.

These imaging and S&I services are now included in the same code as the catheterization. The 2011 injection procedure instructions state, "Cardiac catheterization codes (93452-93461), other than those for congenital heart disease, include contrast injection(s) for imaging typically performed during those procedures."

Left chamber and coronary imaging fall into that "typical" category, so look for a code that includes LHC, left heart imaging, and coronary imaging. That code is most likely 93458.