Wiki LT Heart cath w/selective upper ext

[wblock]

Could you please verify if I have correctly assigned the CPT codes? I am coding for the facility side not the professional side. Are the CPT codes 93459 and 37211? Am I missing a code for the selective placement of the catheter into the brachial artery? Also, are there any modifiers needed? Thank you in advance for your assistance.

This is a Medicare patient:

The procedure is titled:

Left Heart Cath
Selective right and left coronary angiography
LIMA Angiogram
LUE Angiiogram
Thrombolysis of LUE with intra-arterial tPA

Body of the report:
Access: RT femoral artery
Accessed and visualized: LT coronary, RT coronary, LT ventricle, LT internal mammary
LT ventriculogram was performed.
Selective LUE angiogram w/catheter in LT brachial artery show thrombus at the axillo-brachial junction
8mg of intra-arterial tPA was injected. No mechanical thrombolysis -- only chemical thrombolysis with tPA was done due to high risk of thromboembolism.

Thank you so much

 

[Jim Pawloski]

Could you please verify if I have correctly assigned the CPT codes? I am coding for the facility side not the professional side. Are the CPT codes 93459 and 37211? Am I missing a code for the selective placement of the catheter into the brachial artery? Also, are there any modifiers needed? Thank you in advance for your assistance.

This is a Medicare patient:

The procedure is titled:

Left Heart Cath
Selective right and left coronary angiography
LIMA Angiogram
LUE Angiiogram
Thrombolysis of LUE with intra-arterial tPA

Body of the report:
Access: RT femoral artery
Accessed and visualized: LT coronary, RT coronary, LT ventricle, LT internal mammary
LT ventriculogram was performed.
Selective LUE angiogram w/catheter in LT brachial artery show thrombus at the axillo-brachial junction
8mg of intra-arterial tPA was injected. No mechanical thrombolysis -- only chemical thrombolysis with tPA was done due to high risk of thromboembolism.

Thank you so much

I would bill 93459, 36215, 75710. I would bill for infusion thrombolysis since that has to be done over a period of time, not just one injection of TPA.