Someone needs help with this procedure that they were given. This came out, and what I’m assuming when I was reading this earlier is that this is a list of what they did. A lot of times in this report, you’ll see it listed 1, 2, 3, 4. So they did a left heart catheterization, left and right selective coronary angiography, right iliofemoral angiography, management of conscious sedation, abdominal aortography with visualization of both renal arteries.
Now, it looks like there’s tons of stuff going on here. If you were to look at that, I’m sure you’re kind of thinking, “Oh my Lord where do I start?” So, what we’re going to do. We’re going to start with left heart cath (93458) – oh this is what she did. This is actually what she was thinking. She was going to use 93458 with a modifier-26. But she was confused. “I read the CPT book several times. I went online to find the answer and I had no luck. I’m confused. Does this code include everything that was done or am I missing other codes that this procedure was done? Please help.” I think her name is Magda.
Coding Left Heart Cath and Aortography – VIDEO
This is common. You don’t think that you’re the only one out there that has problems with this. She did everything right. She went to the CPT book. She looked at it. She went online. She did her other resources and she still isn’t positive. That’s I think something that coders have to remember – they’re really researchers, actually. I’ve had several people say, “Do we get to use our book?” Yes. You get to use your book for everything because that’s what a coder does.
This is the report that the doctor gave her which is actually a duplicate of what was above. So, I’m not going to repeat that. The thing here, complication – none; there is no complication. So, we get to move aside from that. Don’t think of that. Estimated blood loss 20 ml… local approach for the right femoral artery… I’m not going to read all of that because we’re going to go over it. You guys can access this again later, but this is all the description of what she was reading to come up with her codes.
Go ahead and keep going down a little bit more. We had ejection fraction, that’s important. There’s our conclusion.
Here’s the meat of what you need to know. It’s actually so much simpler when you look at that, say this was a board exam question. This would throw you for a loop, but in the answer, you’re going to break down 93458.
Catheter placement in coronary artery(s) – you notice it says “s “ – for coronary angiography including the intraprocedural injection(s).
See? That’s included – for coronary angiography, imaging, supervision and interpretation. That’s all included.
So, with left catheterization including the intraprocedural injection(s) for left ventriculography when performed.
So, yes, it includes the three main pieces to the cardiac cath: the catheter placement in the coronary vessel, the catheter placement in the heart, and the dye injection and the pictures or the imaging that were taken.
Anyways, if you want to go into more detail or anything, you’d had to see the rest of the upper part, I guess.
But, that’s what they’ll also do, mind you guys, if you’re taking a board exam. They’re going to want to know can you determine if all of those questions… or everything that was done to that patient, are you going to need one code or you’re going to need multiple codes? See, if you go in and you look at that, you break that upper part, you break down what the description of that code was, everything was there. You can do that with a highlighter as well… but you can use a piece of paper to make sure.
That really is an excellent question. I’m glad, you asked that Magda.
All right, thank you.