Q&A LEFT HEART CATH AND ABDOMINAL AORTOGRAPHY WITH VISUALIZATION OF BOTH RENAL ARTERIES

[Magda]

can some please help me code this Dr did the following procedure
Procedure performed
1. Left heart catheterization.
2.Left and Right Selective coronary angiography
3.Right Iliofemoral Angiography
4. Management of conscious sedation
5 Abdominal aortography with visualization of both renal arteries

Know I think just for the left heart cath I use 93458-26 but I am confused I read the cpt book several times, I went online to find the answer and I had no luck, I am confused does this code include everything that was done or am I missing other codes if this procedures where done?
help please

 

[Laureen]

Here is the code description for 93458 broken down:

(2) Catheter placement in coronary artery(s) for coronary angiography,
including intraprocedural injection(s) for coronary angiography,
imaging supervision and interpretation;
(1) with left heart catheterization
including intraprocedural injection(s) for left ventriculography, when performed

So yes it includes the three main pieces to a cardiac cath - the catheter placement in coronary vessels, the catheter placement in the heart, and the dye injection an dthe picutres (imaging)

I'd need to see the op report to comment on your items #3 - 5.

 

[Magda]

Here is the code description for 93458 broken down:

(2) Catheter placement in coronary artery(s) for coronary angiography,
including intraprocedural injection(s) for coronary angiography,
imaging supervision and interpretation;
(1) with left heart catheterization
including intraprocedural injection(s) for left ventriculography, when performed

So yes it includes the three main pieces to a cardiac cath - the catheter placement in coronary vessels, the catheter placement in the heart, and the dye injection an dthe picutres (imaging)

I'd need to see the op report to comment on your items #3 - 5.

 

[Magda]

Hi this the report that Dr gave me so if you can please help me code this it would be great thank you

PROCEDURE PERFORMED
1. Left heart catheterization
2.Left and right selective coronary angiography
3.Right iliofemoral angiography
4.Management of conscious sedation
5. Abdominal aortography with visualization of both renal arteries.

Complication
NONE
Estimated Blood Loss
20 ml
Local approach from the right femoral artery

INDICATION
Chest pain episode, perfusion defect noted in septal region.

PROCEDURE IN DETAIL
The risk and benefits discussed with the patient, counseling the patient. Questions answered, information given. In a standard manner right femoral artery was punctured and a #6 french line was passed. A left coronary angiography was done, and subsequently with the help of JR4 catheter, right coronary artery angiography was performed. with the help of a pigtail catheter, a complete left heart catheterization was done. Left ventriculogram was performed in the right anterior oblique view with a total of 20 ml of dye. Post -LV gram, left ventricular end-diastolic pressure was also performed. With the help of pull-through technique, aortic pressure was also performed. With the help of pull-through technique, aortic pressure was performed and the pigtail catheter was discontinued. Right iliofemoral angiography done to do Angio-Seal. Angio-Seal also has been done.

ANGIOGRAPHY
1. The left main normal.
2.The left main divides into left anterior descending artery and circumflex artery. The left anterior descending artery normal.
3.The diagnol artery is normal.
4.Septal perforator is normal.
5.The cricumflex artery is a moderately large artery and normal.
6.The obtuse marginal artery is normal.
7.Right coronary artery is a large dominant artery and is normal Posterior descending artery normal, posterolateral branch is normal.
8. Marginal branch arising from the right coronary artery is also normal.

Ejection fraction of the left ventricle is in the range of 65% normal
The right iliofermoral artery normal

CONCLUSION
1.This is a grossly normal coronary artery angiography
2. Ejection fraction 65%
3.The abdominal aortography was normal; renal arteries are also normal.