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Is it 93508 or 93510

  1. Default Is it 93508 or 93510
    Medical Coding Books
    Please confirm the CPT code to bill with. Should it be 93508, 93545, 93556 or 93510, 93545 & 93556?

    The op report states:

    NAME OF PROCEDURES
    1. Selective left and right coronary angiography.
    2. Supervision and interpretation of coronary angiography.
    3. Right femoral angiography.

    DESCRIPTION OF PROCEDURE: Following informed consent, the patient
    was brought to the cardiac catheterization laboratory where the right
    groin was prepped in the usual sterile fashion. Then 8 mL of 1%
    Xylocaine was infiltrated into the right groin for local anesthesia.
    The #6 French sheath was introduced into the right femoral artery
    using a modified Seldinger technique. A #6 French JL-4 and a #6
    French JR-4 catheter were used for selective left and right coronary
    angiography respectively. Subsequently all catheters were removed, as
    was the sheath, and manual pressure was applied and good hemostasis
    was obtained. There were no complications during the procedure. The
    total amount of contrast used was 60 mL. Total fluoroscopy time was
    3.4 minutes.

    HEMODYNAMICS
    1. Opening aortic pressure is 138/55.
    2. Final aortic pressure is 166/79.
    DESCRIPTION OF CORONARY ANATOMY
    1. The left main artery has no evidence of significant obstructive
    disease.
    2. The circumflex artery is a diffusely sclerosed vessel less than 2
    mm in diameter.
    3. The left anterior descending artery reveals mild to moderate
    diffuse arteriosclerotic changes, particularly in the distal end,
    without focal obstructive disease. It gives rise to a large diagonal
    branch without focal obstructive disease.
    4. The right coronary artery is a large vessel. It gives rise to the
    PDA. The PDA and PLA reveal diffuse, severe arteriosclerotic changes.
    There is no focal obstructive disease necessitating intervention.
    RIGHT FEMORAL ANGIOGRAPHY: The sheath entry point is visualized
    above the bifurcation. There is no significant stenosis.
    CONCLUSIONS: This coronary angiogram reveals the presence of diffuse
    arteriosclerotic changes of the circumflex artery which was less than
    2 mm, as well as distal traction of the ICA including the PDA and the
    PLA. There is an excellent leak result after previous stent placement
    to the PLA.

  2. #2
    Default
    Quote Originally Posted by peeya View Post
    Please confirm the CPT code to bill with. Should it be 93508, 93545, 93556 or 93510, 93545 & 93556?

    The op report states:

    NAME OF PROCEDURES
    1. Selective left and right coronary angiography.
    2. Supervision and interpretation of coronary angiography.
    3. Right femoral angiography.

    DESCRIPTION OF PROCEDURE: Following informed consent, the patient
    was brought to the cardiac catheterization laboratory where the right
    groin was prepped in the usual sterile fashion. Then 8 mL of 1%
    Xylocaine was infiltrated into the right groin for local anesthesia.
    The #6 French sheath was introduced into the right femoral artery
    using a modified Seldinger technique. A #6 French JL-4 and a #6
    French JR-4 catheter were used for selective left and right coronary
    angiography respectively. Subsequently all catheters were removed, as
    was the sheath, and manual pressure was applied and good hemostasis
    was obtained. There were no complications during the procedure. The
    total amount of contrast used was 60 mL. Total fluoroscopy time was
    3.4 minutes.

    HEMODYNAMICS
    1. Opening aortic pressure is 138/55.
    2. Final aortic pressure is 166/79.
    DESCRIPTION OF CORONARY ANATOMY
    1. The left main artery has no evidence of significant obstructive
    disease.
    2. The circumflex artery is a diffusely sclerosed vessel less than 2
    mm in diameter.
    3. The left anterior descending artery reveals mild to moderate
    diffuse arteriosclerotic changes, particularly in the distal end,
    without focal obstructive disease. It gives rise to a large diagonal
    branch without focal obstructive disease.
    4. The right coronary artery is a large vessel. It gives rise to the
    PDA. The PDA and PLA reveal diffuse, severe arteriosclerotic changes.
    There is no focal obstructive disease necessitating intervention.
    RIGHT FEMORAL ANGIOGRAPHY: The sheath entry point is visualized
    above the bifurcation. There is no significant stenosis.
    CONCLUSIONS: This coronary angiogram reveals the presence of diffuse
    arteriosclerotic changes of the circumflex artery which was less than
    2 mm, as well as distal traction of the ICA including the PDA and the
    PLA. There is an excellent leak result after previous stent placement
    to the PLA.


    I hate to pick on you, but this is a teachable monent. Did a catheter enter the LV and pressures recorded? If not, 93508. If it did, then bill 93510. That's how you tell the difference. The other codes are correct.

    Hopes that helps you. Have a great day tomorrow.
    Jim Pawloski, CIRCC

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