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heart cath and carotid angio??

  1. #1
    Lightbulb heart cath and carotid angio??
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    Hi,
    Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together?

    A complete left heart cath w/imaging and inj proc....

    Bilateral Common Carotid angio and a left subclavian angio.

    This is what I thought??

    36216 RT - Com Carotid Cath placement
    36215 LT - Com Carotid Cath placement
    36215 59 LT - Subclavian Cath placement
    75680 26 - Bilateral Carotid angio
    75685 26 59 - Left Subclavian angio
    93510 26 51 - LT Heart Cath
    93545 59 - Coronary Angio injection
    93543 59 - Lt Vent Angio (he did cross the Aortic Valve) injection
    93556 26 59 - Lt and Rt Coronary Angio
    93555 26 59 - Lt Vent Angio

    Am I even close??

    Thanks, MB Coder
    Last edited by codiologist; 09-20-2009 at 05:25 PM.

  2. Default
    Quote Originally Posted by 01048111 View Post
    Hi,
    Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together?

    A complete left heart cath w/imaging and inj proc....

    Bilateral Common Carotid angio and a left subclavian angio.

    This is what I thought??

    36216 RT - Com Carotid Cath placement
    36215 LT - Com Carotid Cath placement
    36215 59 LT - Subclavian Cath placement
    75680 26 - Bilateral Carotid angio
    75685 26 59 - Left Subclavian angio
    93510 26 51 - LT Heart Cath
    93545 59 - Coronary Angio injection
    93543 59 - Lt Vent Angio (he did cross the Aortic Valve) injection
    93556 26 59 - Lt and Rt Coronary Angio
    93555 26 59 - Lt Vent Angio

    Am I even close??

    Thanks, MB Coder
    Hello,

    W/o reading the report and assuming catheter placements and injections were properly documented I would agree with your codes;however I would not add modifier 59 to the heart cath codes. Most commonly, the heart cath is performed first then catheters are exchanged and then placed in the carotids and subclavian. If the heart cath was done following the carotid angio then it would be appropriate to add modifier 51 and 59 to the heart cath codes. Does this make sense?

    good luck!

    Dolores, CPC, CCC

  3. #3
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by 01048111 View Post
    Hi,
    Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together?

    A complete left heart cath w/imaging and inj proc....

    Bilateral Common Carotid angio and a left subclavian angio.

    This is what I thought??

    36216 RT - Com Carotid Cath placement
    36215 LT - Com Carotid Cath placement
    36215 59 LT - Subclavian Cath placement
    75680 26 - Bilateral Carotid angio
    75685 26 59 - Left Subclavian angio
    93510 26 51 - LT Heart Cath
    93545 59 - Coronary Angio injection
    93543 59 - Lt Vent Angio (he did cross the Aortic Valve) injection
    93556 26 59 - Lt and Rt Coronary Angio
    93555 26 59 - Lt Vent Angio

    Am I even close??

    Thanks, MB Coder
    Without seeing the report the codes look alright with the following exceptions:

    You will probably need to add modifier 59 to both 36215 codes as they will bundle into 36216.
    The LT Subclavian angio is 75710 unless the doc is reading the LT Vertebral.
    Also, if the LT Subclavian is to evaluate the LIMA, then you should not code a 75710 or 75685 but instead should code 93539, and drop the selective catheter placement to the LT Subclavian.

    You should not need modfier 59 for the other codes.

    HTH
    Danny L. Peoples
    CIRCC,CPC

  4. #4
    Default

    Thanks everyone for your response. I billed the claim the way I had mentioned. I will continue to review this site for anymore replies if it come back denied.

    Thanks, MB Coder - CPC

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