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Cath +

  1. #1
    Exclamation Cath +
    Medical Coding Books
    Is it appropriate to bill 93458-26-59, 36200, 75630-26 or not enough information?

    PROCEDURES PERFORMED:

    Left heart catheterization with ventriculography.
    • Abdominal Aortogram with Bilateral Runoffs.
    • Abdominal aortography.
    INDICATIONS: Angina/MI: angina. Lower extremity: claudication.
    SUMMARY
    • Coronary circulation:
    • There was 2-vessel coronary artery disease (LAD and RCA).
    • Proximal RCA: There was a 100 % stenosis.
    • Cardiac structures:
    • Global left ventricular function was normal. EF calculated by contrast ventriculography was 60 %.
    • Right lower extremity vessels:
    • Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects at the common femoral
    artery.
    • Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
    RECOMMENDATIONS:
    • Patient management should include medical treatment.
    • Peripheral surgical revascularization. Will need Fem-Fem bypass.

    Ventricles: There were no left ventricular global or regional wall motion abnormalities. Global left ventricular function was
    normal. EF calculated by contrast ventriculography was 60 %.
    Coronary circulation: The coronary circulation is right dominant. There was 2-vessel coronary artery disease (LAD and
    RCA). Proximal LAD: There was a 50 % stenosis just after D1. Proximal RCA: There was a 100 % stenosis. Distal RCA:
    The artery was supplied by heavy collaterals from the left.
    Aorta: Abdominal aorta: The segment was normal in size. There was heavy atherosclerosis.
    Abdominal vessels: Left renal: Normal. Right renal: Normal.
    Left lower extremity vessels: Left common iliac: There was a 40 % stenosis at the site of a prior stent. There was three
    vessel runoff.
    Right lower extremity vessels: Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects
    at the common femoral artery. Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
    Procedure:
    1. Left femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using
    the modified Seldinger technique.
    2. Abdominal Aortogram with Bilateral Runoffs.
    3. Abdominal aortography. A catheter was placed and contrast was injected.
    Complications:
    1. No complications occurred during the cath lab visit.

  2. #2
    Location
    Birmingham, Alabama
    Posts
    889
    Default
    Quote Originally Posted by amym View Post
    Is it appropriate to bill 93458-26-59, 36200, 75630-26 or not enough information?

    PROCEDURES PERFORMED:

    Left heart catheterization with ventriculography.
    • Abdominal Aortogram with Bilateral Runoffs.
    • Abdominal aortography.
    INDICATIONS: Angina/MI: angina. Lower extremity: claudication.
    SUMMARY
    • Coronary circulation:
    • There was 2-vessel coronary artery disease (LAD and RCA).
    • Proximal RCA: There was a 100 % stenosis.
    • Cardiac structures:
    • Global left ventricular function was normal. EF calculated by contrast ventriculography was 60 %.
    • Right lower extremity vessels:
    • Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects at the common femoral
    artery.
    • Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
    RECOMMENDATIONS:
    • Patient management should include medical treatment.
    • Peripheral surgical revascularization. Will need Fem-Fem bypass.

    Ventricles: There were no left ventricular global or regional wall motion abnormalities. Global left ventricular function was
    normal. EF calculated by contrast ventriculography was 60 %.
    Coronary circulation: The coronary circulation is right dominant. There was 2-vessel coronary artery disease (LAD and
    RCA). Proximal LAD: There was a 50 % stenosis just after D1. Proximal RCA: There was a 100 % stenosis. Distal RCA:
    The artery was supplied by heavy collaterals from the left.
    Aorta: Abdominal aorta: The segment was normal in size. There was heavy atherosclerosis.
    Abdominal vessels: Left renal: Normal. Right renal: Normal.
    Left lower extremity vessels: Left common iliac: There was a 40 % stenosis at the site of a prior stent. There was three
    vessel runoff.
    Right lower extremity vessels: Right common iliac: There was a 100 % stenosis at the site of a prior stent. Reconnects
    at the common femoral artery. Right posterior tibial: There was a 100 % stenosis. There was two vessel runoff.
    Procedure:
    1. Left femoral artery access. The puncture site was infiltrated with local anesthetic. The vessel was accessed using
    the modified Seldinger technique.
    2. Abdominal Aortogram with Bilateral Runoffs.
    3. Abdominal aortography. A catheter was placed and contrast was injected.
    Complications:
    1. No complications occurred during the cath lab visit.

    I see :
    93458
    75630-26,59

    I would not code catheter placement into the aorta, it is bundled with the heart cath.

    HTH
    Danny L. Peoples
    CIRCC,CPC

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