# adenosine infusions with right heart cath



## amykwhitt (Apr 18, 2013)

Can you use the IV infusion codes when you do a right heart cath? A right heart cath only was done and adenosine was infused IV during the case. We have code 96365. Can you use that code?


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## RSammons (Apr 18, 2013)

NCCI manual (http://www.cms.gov/Medicare/Coding/...ndex.html?redirect=/nationalcorrectcodinited/) Click on this zip file near the bottom of the page: NCCI Policy Manual for Medicare Services - Effective January 1, 2013 [ZIP, 696KB] 

Chapter 11-section I-Cardiovascular Services has coding instructions.  
4. A number of diagnostic and therapeutic cardiovascular procedures (e.g., CPT codes 92950-92998, 93451-93533, 93600-93624, 93640-93657) routinely utilize intravenous or intra-arterial vascular access, routinely require electrocardiographic monitoring, and frequently require agents administered by injection or infusion techniques. Since these services are integral components of the more comprehensive procedures, codes for routine vascular access, ECG monitoring, and injection/ infusion services are not separately reportable. Fluoroscopic guidance is integral to diagnostic and therapeutic intravascular procedures and is not separately reportable. HCPCS/CPT codes describing radiologic supervision and interpretation for specific interventional vascular procedures may be separately reportable.

Was this just a regular IV infusion or were hemodynamics recorded before, during and after administration of amiodarone?  I am not sure that I have seen amiodarone used for CPT 93463, but the documentation guidelines require during the procedure hemodynamics are recorded before, during and after.  

Regular IV infusions (hydration or theurapeutic), IV Push, foley insertion, EKGs--lots of things are considered integral to the procedure and cannot be reported separately.


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## amykwhitt (May 3, 2013)

I was asking about adenosine not amiodorone and yes the vitals were monitored pre,during and post case.


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