# Rt heart cath for evaluation for pulmonary hypertension



## NESmith (Apr 4, 2011)

Please tell me if it would be appropriate to bill this procedure as 93451-26
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Procedure state: A needle was inserted into the rt femoral vein without difficulties. the guidewire was then inserted. The cath was then inserted over the guidewire and the dilator as well as the guidelines were removed. Then, the Swan-Ganz cath was inserted through the femoral vein cth. Fluoroscopy was used to guide the Swan-Ganz catheter. Initially the Swan-ganz cath was guided to the superior vena cava and a saturation run was done. The patient had a saturation of 73% in the superior vena cava. The cath was then guided into the rt atrium, into the rt ventricle and into the pulmonary artery and a saturation run was done there as well, and the saturation was 72%. Due to the difference of less than 10%, no more further saturation runs were done. The pressures were recored in the rt atrial, rt ventricular as well as a wedge pressure was obtained as well. They are as follows: the rt attrial proessure was 10/9. RV 40/2 Pa pressure initially was 32/11 with a mean of 19 and the wedge was 6. These conditions were at rest. 
The patient was then exercised for 2 minutes, she was given a 1 l bag in each hand and she exercised for at least 2 minutes. Her PA pressure was then 43/16 with a mean of 26. The wedge still remained at 6. Then, the cardiac output was measured by thermodilution and the cardiac output was 6.6. The balloon was then deflated and the Swan-ganz cath was removed. Please give me thoughts on this as if this is coded correctly. I am new to cardio. Thanks for your help


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