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Lt and Rt Hrt Catheterization Codes

jaud63

Networker
Local Chapter Officer
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76
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0
Please code the following; I am verfiying the codes our MD's have chosen for use.

Diag Procedure: Lt Hrt Cath, Rt Hrt Cath, coronary angiogram
PCI Procedure: Drug eluting coronary stent, ACT, closure device

Conclusions: Severe 3 vessel CAD with successful DES stents to proximal LAD and prox RCA both converted to 0%. Non acute OM2 branch of circ left alone. Rt Hrt cath pressures are all normal but cardiac output reflects LV dysfunction. See nuclear and Echo results. Normal rt hrt pressure imply the LV dysfunction is relatively new.

Angiographic Findings:

LMCA: Normal

LAD: Prox LAD: 95% stenosis 8 mm length reduced to 0%. Pre-procedure T1M1 flow was noted. A good run off was present. The lesion was diagnosed as a high risk lesion. Post Procedure: T1M1 III flow was present.

Devices Used: Abbott Voyager 2.5 X 12mm (Total duration: 30 seconds, two inflations to max pressure of: 14 ATM) Boston Scientific Promus 2.75 x 12 mm
(Total duration: 7 seconds, 1 inflation to max pressure : 16 ATM)

LCX: Moderate disease. 80% OM2 lesion treated conservatively

RCA: Prox RCA:99% stenosis 10mm length reduced to 0%. Pre-procedure T1M1 flow was noted. The lesion was diagnosed as a low risk lesion.

Post procedure T1M1 flow was present.

Devices used: Abbott Voyager 2.0 x 12mm

Catheters/Guides: Cordis 4.0 Fr JL 4.0 was used for LT Coronary Angiography, Cordis 4,0 Fr JR was used for Rt Coronary Angiography, Medtronic G-6 Fr EBU 4.0 was used for Lt coronary angiography, Medtronic G-6 Fr Jr EBU was used for Rt coronary angiography, Medtronic Gr Fr NOTO was used for Rt coronary angiography, Cordis 4.0 Fr Pigtail Angled ws used for LV Pressures, Cordis 4.0 Fr Jr was used for LV Pressures, Cordis 4.0 Fr Pigtail Angled was used for LV Pressures.

Pressure:
PCW-7/8(6)
PA- 25/7 (11)
RV-27/-1,2
RA- 4/1 (1)
AO - 117/63 (84)
LV - 126/-3, 16
LL - 124/-3,16

Thanks. It would be much appreciated by anyone.
 

rcosta

Contributor
Local Chapter Officer
Messages
10
Location
Jefferson County Coders, Alabama
Best answers
0
92980-RC, 92984-LD, 93526-26, 93545, 93556-2659, assuming physician did an LV gram(not documented) then code 93543, 93555-2659. You will need the 59 modifiers as S&I will global with stent and angioplasty code.
 

rgrimes

Networker
Messages
38
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0
LT and RT cath - 93526
imaging supervision of catheter - 93555
Coronary Angiogram - 93545
imaging supervision of angiogram - 93556

I'm not sure on the stents but hope this part helps you

Ruth Ann
Accucode medical Billing
 

deeva456

Expert
Messages
275
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0
I agree with RCOSTA, ok to bill with the codes listed. If a left ventriculography was done, it is not clearly documented.

good Luck!

Dolores CPC-CCC
 

jaud63

Networker
Local Chapter Officer
Messages
76
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0
Lt and Rt Hrt Cath w/angiography Addtl ? for rcosta

92980-RC, 92984-LD, 93526-26, 93545, 93556-2659, assuming physician did an LV gram(not documented) then code 93543, 93555-2659. You will need the 59 modifiers as S&I will global with stent and angioplasty code.
Thanks a ton for the instruction.

Just one more question.

LV gram was documented in conclusions that I did not enter. Which part indicates (PTCA)angioplasty?

Thanks:)
 
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