Cardiology Coding Alert

Question: How should I report single vessel coronary angiography with intravascular ultrasound?

Ohio Subscriber

Answer: For angiography on only one coronary artery, you should report 93508 (Catheter placement in coronary artery[s], arterial coronary conduit[s], and/or venous coronary bypass graft[s] for coronary angiography without concomitant left heart catheterization). Be sure to append modifier 26 (Professional component) if the cardiologist performs the procedure in a facility other than the physician's office.

You should also report codes for the injection procedure and imaging:

• 93545 -- Injection procedure during cardiac catheterization; for selective coronary angiography (injection of radiopaque material may be by hand)

• 93556 -- Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits (whether native or used in bypass).

Code 93556 also requires modifier 26 for services in a facility. You should not use modifier 26 with 93545, however, because it describes physician services only.

Finally, you should report the intravascular ultrasound (IVUS) using +92978-26 (Intravascular ultrasound [coronary vessel or graft] during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel [List separately in addition to code for primary procedure]).