Wiki Need official reference for documentation of LT heart cath crossing aortic valve

MNovoselatz

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Good morning,

I'm looking for an official reference to prove that documentation of the crossing of the aortic valve is necessary in order to code a left heart catheterization. Some at my facility have been told that as long as pressures are documented, a LT heart cath can be coded. In my experience, I have been told those pressures could be obtained on the aorta side of the aortic valve without the catheter traversing the aortic valve.

Thank you!
Michelle
 
You won't find anything that states exactly what you're looking for. Is it best practice, of course. But there are some measurements that can only be obtained by crossing the aortic valve (LVEDP) is one of them.
 
CPT shows for 93452, a catheter in the left ventricle. 93458 is for a left heart which includes catheterization of the left heart, LV gram, and injections of the coronary arteries. Dr. Zielske in his book states that the left heart catheterization requires catheter placement in the left heart chamber with recording of hemodynamics of the left heart (systolic and end-diastolic left ventricular pressures.
HTH,
Jim Pawloski, CIRCC
 
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