Ventriculography w/ Cath

kevbshields

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This is creating contoversy for some of us . . .

We have external (OP) coders validating OP encounters for my facility. However, the problem is that these folks take the report title, which usually reads, "coronary angiography" and tack on code 93508.

The issue that I (and my colleagues) have with this is that a heart cath is being performed . . . a different terminology is just being used than what these other coders are accustomed to. Point being, in each of the cases we have identified, the Interventional Cardiologist states and clearly documents that ventriculography was performed.

Correct me if I'm wrong here, but in order to perform ventriculography, you've got to inject dye into the ventricle(s). And, if you're accessing/injecting the ventricles, you've done a heart cath (see page 393 of the Professional Edition of CPT-4 2007 for further specifics on 93508). If that is the case, that ventriculography requires accessing the ventricle(s), then 93508 cannot be correct and we need to educate them on this issue.

Any assistance would be appreciated. We've a consensus at my facility, I just want to hear some outside voices (in case I need them).

Thanks!
 

tcoder

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Hi, Kevin!

I've been coding cardiology for a year now and here's what I know...

You are right; when the documentation clearly states 'Left Ventriculography"
the only way they can do this is crossing the aortic valve - 93510.
Pressures are then taken there and as they pull back across the valve
antegrade. When we have doc only stating 'Coronary angiography" without
any mention of ventriculography or any results as 'Pressures Taken', then
the only code that fits is 93508.

Hope this helps. :)

Terri Byrne
St. Louis, Mo
 

kevbshields

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Thanks a heap.

Actually I had to pull one of the clinicians down to give an update to those "non-believers." I felt assured of what I was saying, but just having other folks question that always gives you pause . . .

Thanks!

Have a terrific weekend.
 
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