Remember.... the biggest thing with catheterization codes is route of entry (i.e. venous or arterial) and final location. Included is the reason for the catheterization.
If you read the two codes you ask about in the CPT book, you'll notice that 93458 is used when the catheter is placed through the coronary artery(s) for cornoary angiography with left heart catheterization. 93452 is used for left heart catheterization when left ventriculography is the reason for the catherterization.
As you go through the cardiovascular section of the CPT, you're going to notice that this is going to be the hardest section to code from. Don't feel bad if you're having a hard time with this. I know coders with as much as 30 years of experience who have a hard time with it.
As far as what to look for in the chart notes..... The cardiovascular section is going to be like any other section. You want to look for action and the reason for the action. After that, just match up the CPT the best you can. I know this isn't much of an explination, but it's much easier for me to explain using actual chart notes.
Hope this helps.
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