# Nitric oxide challenge



## newmy9 (Nov 20, 2007)

I am not sure what code to use for a nitric oxide challenge with a right heart cath, is it 95012 or 94770, or something else?  
thanks


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## ladame33 (Jan 2, 2008)

*Nitric Oxide Challenge*

Here is the answer that I got from Dr. Z of Ingram & Assoc consultants:

Nitric oxide administration and testing is included in the cardiac catheterization procedure. One of the reasons the AMA created separate codes for cardiac catheterization on patients with congenital anomalies is because of the additional testing that is performed that cannot be reported separately. In CPT Assistant April 1998, page 1, the AMA stated:
"Cardiac catheterization in congenital heart disease patients is frequently more time consuming because of small vessel size, the multiple measurements that must be made, the instability of the patients (particularly neonates and infants), the frequency of multiple sites of arterial-venous admixture, and performance of other required interventions (eg, Rashkind procedure). For example, evaluation of pulmonary artery hypertension may require administration of oxygen, nitric oxide, or other agents and repeated measurement of pulmonary blood flow pressures and cardiac output."

If respiratory therapy is involved they may be charging the following code, which wouldn't be used by the cath lab and probably isn't really appropriate for this study:
95012 Nitric oxide expired gas determination

*When the cardiac cath lab performs this study, it is included in the heart cath. *Dr. z 12-20-07


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