If the patient is a post-bypass patient with a LIMA bypass then code the 93539.
The 93539 is for any bypass that used an artery to do the bypass. The most common artery the surgeon pulls is the Left Internal Mammary artery (LIMA)
The 93540 is for any bypass that used a vein to do the bypass. The most common vein they pull is the Saphenous vein from the upper leg.
Use Dx V45.81 to show this is a post-bypass patient
Sometimes the Cath will show the bypass conduits (artery or vein) are disease or plugged. If the LIMA graft is, then you can code 414.04. For a vein bypass you can code 414.02
93539 Injection procedure during cardiac catheterization; for selective opacification of arterial conduits (eg, internal mammary), whether native or used for bypass
93540 Injection procedure during cardiac catheterization; for selective opacification of aortocoronary venous bypass grafts, 1 or more coronary arteries
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