Is it 93508 or 93510

peeya

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Please confirm the CPT code to bill with. Should it be 93508, 93545, 93556 or 93510, 93545 & 93556?

The op report states:

NAME OF PROCEDURES
1. Selective left and right coronary angiography.
2. Supervision and interpretation of coronary angiography.
3. Right femoral angiography.

DESCRIPTION OF PROCEDURE: Following informed consent, the patient
was brought to the cardiac catheterization laboratory where the right
groin was prepped in the usual sterile fashion. Then 8 mL of 1%
Xylocaine was infiltrated into the right groin for local anesthesia.
The #6 French sheath was introduced into the right femoral artery
using a modified Seldinger technique. A #6 French JL-4 and a #6
French JR-4 catheter were used for selective left and right coronary
angiography respectively. Subsequently all catheters were removed, as
was the sheath, and manual pressure was applied and good hemostasis
was obtained. There were no complications during the procedure. The
total amount of contrast used was 60 mL. Total fluoroscopy time was
3.4 minutes.

HEMODYNAMICS
1. Opening aortic pressure is 138/55.
2. Final aortic pressure is 166/79.
DESCRIPTION OF CORONARY ANATOMY
1. The left main artery has no evidence of significant obstructive
disease.
2. The circumflex artery is a diffusely sclerosed vessel less than 2
mm in diameter.
3. The left anterior descending artery reveals mild to moderate
diffuse arteriosclerotic changes, particularly in the distal end,
without focal obstructive disease. It gives rise to a large diagonal
branch without focal obstructive disease.
4. The right coronary artery is a large vessel. It gives rise to the
PDA. The PDA and PLA reveal diffuse, severe arteriosclerotic changes.
There is no focal obstructive disease necessitating intervention.
RIGHT FEMORAL ANGIOGRAPHY: The sheath entry point is visualized
above the bifurcation. There is no significant stenosis.
CONCLUSIONS: This coronary angiogram reveals the presence of diffuse
arteriosclerotic changes of the circumflex artery which was less than
2 mm, as well as distal traction of the ICA including the PDA and the
PLA. There is an excellent leak result after previous stent placement
to the PLA.
 

Jim Pawloski

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Location
Ann Arbor
Best answers
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Please confirm the CPT code to bill with. Should it be 93508, 93545, 93556 or 93510, 93545 & 93556?

The op report states:

NAME OF PROCEDURES
1. Selective left and right coronary angiography.
2. Supervision and interpretation of coronary angiography.
3. Right femoral angiography.

DESCRIPTION OF PROCEDURE: Following informed consent, the patient
was brought to the cardiac catheterization laboratory where the right
groin was prepped in the usual sterile fashion. Then 8 mL of 1%
Xylocaine was infiltrated into the right groin for local anesthesia.
The #6 French sheath was introduced into the right femoral artery
using a modified Seldinger technique. A #6 French JL-4 and a #6
French JR-4 catheter were used for selective left and right coronary
angiography respectively. Subsequently all catheters were removed, as
was the sheath, and manual pressure was applied and good hemostasis
was obtained. There were no complications during the procedure. The
total amount of contrast used was 60 mL. Total fluoroscopy time was
3.4 minutes.

HEMODYNAMICS
1. Opening aortic pressure is 138/55.
2. Final aortic pressure is 166/79.
DESCRIPTION OF CORONARY ANATOMY
1. The left main artery has no evidence of significant obstructive
disease.
2. The circumflex artery is a diffusely sclerosed vessel less than 2
mm in diameter.
3. The left anterior descending artery reveals mild to moderate
diffuse arteriosclerotic changes, particularly in the distal end,
without focal obstructive disease. It gives rise to a large diagonal
branch without focal obstructive disease.
4. The right coronary artery is a large vessel. It gives rise to the
PDA. The PDA and PLA reveal diffuse, severe arteriosclerotic changes.
There is no focal obstructive disease necessitating intervention.
RIGHT FEMORAL ANGIOGRAPHY: The sheath entry point is visualized
above the bifurcation. There is no significant stenosis.
CONCLUSIONS: This coronary angiogram reveals the presence of diffuse
arteriosclerotic changes of the circumflex artery which was less than
2 mm, as well as distal traction of the ICA including the PDA and the
PLA. There is an excellent leak result after previous stent placement
to the PLA.


I hate to pick on you, but this is a teachable monent. Did a catheter enter the LV and pressures recorded? If not, 93508. If it did, then bill 93510. That's how you tell the difference. The other codes are correct.

Hopes that helps you. Have a great day tomorrow.
Jim Pawloski, CIRCC
 
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