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Left/Right Heart Cath w/02 Sat

  1. #1
    Daytona/Orlando Florida
    Default Left/Right Heart Cath w/02 Sat
    Medical Coding Books
    Could I get some expert help here please. I am confused on which code I should be using for this Catherization. Should it be the 93460 or 93531??

    Procedure: Under sterile conditions and local anesthesia, a 7-french sheath was inserted percutaneously in the right femoral vein and a 6-french sheath in the right femoral artery. Next, a Swan-Ganz catheter was advanced into the pulmonary artery where hemodynamic pressures were obtained. Serial 02 saturations were done. Next, the coronaries were visualized visualized using a Judkins left 3.5 and 6-French 3DRC. The left ventriculogram was done using a 6-French pigtail. At the end of the procedure, a hand injection was done through the side are of the sheath in the right common femoral artery and hemostasis was obtained by using Angio-Seal.

    Summary of Hemodynamics: The heart rate was 58 beats per minute, sinus rhythm. Right atrial pressure was A-wave of 17,, V-wave of 16 and mean of 16. Right ventricular pressure was 30/13. Pulmonary artery pressure was 30/15. Wedge pressure was A-wave of 17, V-wave of 17 and mean of 15. Aorta pressure was 130/70. Left ventricular pressure was 130/19.

    The above hemodynamic profile is consistent with borderline elevated right heart pressures with elevated RA an RV pressures.

    The Fick cardiac output was 5.0 with an index of 2.5. The serial 02 saturations were as follows: The IVC was 74%, Rv 73%, PA 73% and the wedge 02 saturation was 96%. The femoral artery 02 saturation was 100%.

    The above 02 saturation profile shows no evidence of an oxygen step-up or a shunt.

    I believe this is all you should need to assist me with this - but if more of the report is needed please let me know.

    Thanks so much
    Diana S. Garrison, CPC
    Client Services Manager
    RCM Professionals, LLC

  2. #2
    Richardson, TX
    I would use 93460 unless congenital anomalies are documented as the reason for the R&L heart cath.
    Julie Graham, BA, CPC, CCC

  3. #3
    Daytona/Orlando Florida
    Thanks so much. That is what I did - appreciate your input.
    Diana S. Garrison, CPC
    Client Services Manager
    RCM Professionals, LLC

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