Wiki Cardiology Question - Clarify coding a procedure - 93454 vs 93458

[kokomax]

Good Morning! Can someone please clarify the coding on this report...93454 vs 93458

Selective Coronary Angiography

After obtaining informed consent, the patient was brought to the Cath Lab. He was prepped and draped in order to obtain a sterile field. Under my supervision the patient was mildly sedated with IV Versed and Fentanyl. During the procedure the blood pressure, heart rate and pulse ox were continuously monitored by the nurse. My face-to-face time with the patient was 20 minutes. The right wrist was anesthetized with 1% lidocaine. The right radial artery was cannulated using modified Seldinger technique was 5 French slender sheath. A Jacky catheter was then cannulate the left main and angiography was performed different views, the same catheter as then cannulated the RCA and angiography was performed different views at this point all the catheters were removed the patient tolerated the procedure well, there were no complications, he left the cath lab hemodynamically stable and neurologically intact. TR band was applied with good hemostasis.

I say 93454, 93015 but a Manager is saying 93458...

I'd really appreciate any feed back on this - we have a lunch riding on this!!! LOL!!!

 

[oe00219]

According to this documentation its 93454

 

[ldickerson58]

Good Morning! Can someone please clarify the coding on this report...93454 vs 93458

Selective Coronary Angiography

After obtaining informed consent, the patient was brought to the Cath Lab. He was prepped and draped in order to obtain a sterile field. Under my supervision the patient was mildly sedated with IV Versed and Fentanyl. During the procedure the blood pressure, heart rate and pulse ox were continuously monitored by the nurse. My face-to-face time with the patient was 20 minutes. The right wrist was anesthetized with 1% lidocaine. The right radial artery was cannulated using modified Seldinger technique was 5 French slender sheath. A Jacky catheter was then cannulate the left main and angiography was performed different views, the same catheter as then cannulated the RCA and angiography was performed different views at this point all the catheters were removed the patient tolerated the procedure well, there were no complications, he left the cath lab hemodynamically stable and neurologically intact. TR band was applied with good hemostasis.

I say 93454, 93015 but a Manager is saying 93458...

I'd really appreciate any feed back on this - we have a lunch riding on this!!! LOL!!!

This would be a 93454. in order to bill for the left heart cath, 93458, the physician would need to document that he crossed the aortic valve and hemodynamic data/pressures. This is not listed in this document. And why are you wanting to bill code 93015 with this?

 

[CBLENNIE]

And why are you wanting to bill code 93015 with this?

Are you trying to bill 93015 because of the following information in the note you posted?

During the procedure the blood pressure, heart rate and pulse ox were continuously monitored by the nurse.

These activities should be performed as part of the 93454, these are basic bodily functions that should be monitored during a procedure.

Additionally, 93015 is defined as follows per EncoderPro:



Obviously, the patient was not exercising during the procedure, which is required for 93015 to be consider as billable depending on what a patient is being tested/seen for on a given date of service.