csorensen21@yahoo.com
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Procedure: Right and left heart catherization
Indication: Worsening shortness of breath with evidence suggestive of sever aortic stenosis on echocardiography.
Description of Procedure: The patient was taken to the cath lab. The right groin was prepped and draped in the usual manner and was anesthetized with 1% lidocaine. A 6-french sheath was placed in the right femoral artery using a modified Seldinger technique without any difficulty. Similarly, a 7-French sheath was placed in the right femoral vein. Right heart catherization was performed using a 7-French Swan-Ganz catheter. I then used a 6-French multipurpose catheter and was able to get access into the left ventricle using a regular J-wire. Left ventriculography was performed in the RAO projection with multipurpose catheter in the left ventricle with several mL of contrast using hand injection. Several minutes later, I performed a left ventricular aortic pullback and then proceeded with measurement of cardiac outputs using the thermodilution technique. Subsequently, I proceeded with left and then right coronary angiography using 6-French JL4 and JR4 catheters. Finally, both sheaths wee removed and hemostasis to the right arterial side was achieved using the Mynx device. The patient tolerated the procedure well and left the cath lab in stable condition.
I'm not sure what codes to use in this situation. I could use some help! Can I bill code 93561 and 93503 in addition to the RT/LT heart cath?
Thank you!
Carrie Sorensen, CPC
Indication: Worsening shortness of breath with evidence suggestive of sever aortic stenosis on echocardiography.
Description of Procedure: The patient was taken to the cath lab. The right groin was prepped and draped in the usual manner and was anesthetized with 1% lidocaine. A 6-french sheath was placed in the right femoral artery using a modified Seldinger technique without any difficulty. Similarly, a 7-French sheath was placed in the right femoral vein. Right heart catherization was performed using a 7-French Swan-Ganz catheter. I then used a 6-French multipurpose catheter and was able to get access into the left ventricle using a regular J-wire. Left ventriculography was performed in the RAO projection with multipurpose catheter in the left ventricle with several mL of contrast using hand injection. Several minutes later, I performed a left ventricular aortic pullback and then proceeded with measurement of cardiac outputs using the thermodilution technique. Subsequently, I proceeded with left and then right coronary angiography using 6-French JL4 and JR4 catheters. Finally, both sheaths wee removed and hemostasis to the right arterial side was achieved using the Mynx device. The patient tolerated the procedure well and left the cath lab in stable condition.
I'm not sure what codes to use in this situation. I could use some help! Can I bill code 93561 and 93503 in addition to the RT/LT heart cath?
Thank you!
Carrie Sorensen, CPC