Wiki R&lhc

[nancy.anselmo@ccrheart.com]

Scenerio:
Dr. did a L&RHC w/selective coronary angiography, left ventriculography, bypass graft angiography, aortography

Procedure: Left & right groins were prepped in the usual sterile fashion and 2% lidocaine was infused subcutaneously until adequate anesthesia was obtained. The pt has a known total occlusion of the right external iliac artery, therefore arterial access was accessed in the left common femoral artery and right common femoral vein was also accessed for a RHC. A 7 French sheath was placed in the right common femoral vein and a 6 French sheath in the right common femoral artery. A Swan-Ganz catheter was used to perform RHC and a JL4 & JR4 as well as an IMA catheter for coronary angiography and bypass graft angiography and a pigtail catheter for aortography and left ventriculography.At the conclusion of the procedure, iliac angiography was performed that demonstrated a high bururcation of the common femoral and deep profunda with moderate atherosclerosis indicating manual compression for appropriate hemostasis.

I billed 93561-26
but do I bill 75625-26-59 or 75630-26-59 for interpretation of the supervalvular aortagram?
Thank you Nancy

 

[dpeoples]

Scenerio:
Dr. did a L&RHC w/selective coronary angiography, left ventriculography, bypass graft angiography, aortography

Procedure: Left & right groins were prepped in the usual sterile fashion and 2% lidocaine was infused subcutaneously until adequate anesthesia was obtained. The pt has a known total occlusion of the right external iliac artery, therefore arterial access was accessed in the left common femoral artery and right common femoral vein was also accessed for a RHC. A 7 French sheath was placed in the right common femoral vein and a 6 French sheath in the right common femoral artery. A Swan-Ganz catheter was used to perform RHC and a JL4 & JR4 as well as an IMA catheter for coronary angiography and bypass graft angiography and a pigtail catheter for aortography and left ventriculography.At the conclusion of the procedure, iliac angiography was performed that demonstrated a high bururcation of the common femoral and deep profunda with moderate atherosclerosis indicating manual compression for appropriate hemostasis.

I billed 93561-26
but do I bill 75625-26-59 or 75630-26-59 for interpretation of the supervalvular aortagram?
Thank you Nancy

To answer the question I will assume you actually have a dictation of the interpretation of the "IMA catheter for coronary angiography and bypass graft angiography and a pigtail catheter for aortography and left ventriculography", and also pressures for the LT and RT ventricles.

I do not see mention of a "supravalvular aortogram" or the aortic root, so I would not bill anything for that. The Injection for the iliac is to evaluate the access site and is inherent to the procedure and should not be separately billed.

So, I would code 93461-26 which covers L/RHC and angios of coronaries and bypass grafts. I do not understand why you would code 93561? Perhaps that was a typo?

HTH