Wiki Coronary Angiography

Create Wiki
L

lauraleerdh

New
Messages
9
Location
Baden, PA
Best answers
0
Hello,
I'm seeking advice as to what resources to go to to improve my understanding and skills for coding catheterizations.
In Practicum, a case with:
1. Left heart catheterization with ventriculography. Catheter wasadvanced across the aortic valve to the left ventricle under fluoroscopic guidance. Contrast wasinjected with a power injector.

2. Selective left coronary angiography. Catheter was advanced intothe left coronary vessel ostium under fluoroscopic guidance. Contrast was injected by hand.Images were obtained in multiple projections.

3. Selective right common iliac angiography under fluoroscopic guidance. Catheter was advanced into the right common iliac artery. Contrast was injected by hand.Images were obtained.

4. Selective left internal mammary angiography, under fluoroscopic guidance. A catheter was advanced into the left internal mammary artery. Contrast was injected by hand. Images were obtained.

Only code 93458 was used. I'm not understanding why the other selective angiographies weren't coded, especially the common Iliac, and even the internal mammary, it seems the catheter would need to be pulled back from its location in the Left Coronary Artery to access those arteries. The Left internal mammary angiography also doesn't indicate its a bypass graft for 93459 to be used.

Thank you for your guidance.
 
If the patient has coronary artery disease and may go have a CABG, the internal mammary artery may be used for bypass. That is when 93459 can be used. The iliac artery was probably closed with a closure device, so the imaging is bundled in the procedure.
HTH,
Jim
 
Jim Pawloski said:
If the patient has coronary artery disease and may go have a CABG, the internal mammary artery may be used for bypass. That is when 93459 can be used. The iliac artery was probably closed with a closure device, so the imaging is bundled in the procedure.
HTH,
Jim
Click to expand...
Thank you for replying and explanation. From the angiographs, the patient was diagnosed with CAD. does it matter that the report doesn't indicate if the patient is being considered for CABG? or are we to ascertain that just from the diagnosis of CAD that CABG may be performed?

Also, do you have any resources that I could study/refer to to improve my cardiology coding skills? I'm a new coder workign through Practicum.

Thank you.
 
It doesn't matter if the physician doesn't indicate if a CABG will happen. So basically, if the mammary artery is injected, code for grafts- either 93455 or 93459. My best resource is Z-Health Publishing. The books are on the expensive side however it is a great resource. MedLearn is also good, however how it was written for the physician so the information is not the best,
HTH,
Jim
 
You must log in or register to reply here.
Top