# Atrial Septal Defect Closure with Transseptal Puncture



## leahlhaynie (Oct 29, 2010)

Hello,

One of our doctors performed a purcutaneous transcath. closure (93580) with ICE (93662). However, he also performed a transseptal puncture. He wanted to use 93533, which is not allowed. Any assistance on properly coding this would be appreciated! 

_It was felt that the tunnel was long and the device positioning was inadequate. At this time, the device was withdrawn and we decided to do a transseptal puncture for adequate device placement. A transseptal puncture was done using a Brockenbrough needle. The device was then redeployed and adequate positioning was confirmed with intracardiac echocardiography as well as fluroscopy._


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## theresa.dix@tennova.com (Nov 1, 2010)

leahlhaynie said:


> Hello,
> 
> One of our doctors performed a purcutaneous transcath. closure (93580) with ICE (93662). However, he also performed a transseptal puncture. He wanted to use 93533, which is not allowed. Any assistance on properly coding this would be appreciated!
> 
> _It was felt that the tunnel was long and the device positioning was inadequate. At this time, the device was withdrawn and we decided to do a transseptal puncture for adequate device placement. A transseptal puncture was done using a Brockenbrough needle. The device was then redeployed and adequate positioning was confirmed with intracardiac echocardiography as well as fluroscopy._





According to CPT, all of the heart cath codes relative to congenital defects are included and not separately coded. Reference the parenthetical notes following code 93580.

Now for some reason if the device isnt placed then you could go ahead and code the cath.

SO the answer is No you cannot use 93533 along with 93580. its included.


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## leahlhaynie (Nov 1, 2010)

Right, I read that I could not code that cath along with it. I was trying to determine if there was an appropriate way to code the transseptal puncture. Apologies if it was phrased poorly.

Thank you!


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