# Did not cross aortic valve



## OPENSHAW (Apr 29, 2013)

Our doctor did the following:

Left and right heart cath, he did not cross aortic valve, he said he did not cross in on lhc
lima
svg
thoracic aortogram

the diagnosis are:
Cad, 414.00
severe mr, 424.0
aortic insufficiency, 424.1

cpt codes are 93461 and 75600 ?


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## HEMINGWAYT (Apr 29, 2013)

If he didn't cross the aortic valve then he didn't do a LHC.  Just based on the documentation you listed, I don't see any justification for the RHC either.  If only coronary angiogram with graphs were performed it would be 93455.  I'm also not sure the reason for the thoracic aortogram, if it was done for roadmapping purposed, it is not billable.


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## dpeoples (Apr 30, 2013)

HEMINGWAYT said:


> If he didn't cross the aortic valve then he didn't do a LHC.  Just based on the documentation you listed, I don't see any justification for the RHC either.  If only coronary angiogram with graphs were performed it would be 93455.  I'm also not sure the reason for the thoracic aortogram, if it was done for roadmapping purposed, it is not billable.



I agree with Tammy on the heart cath code 93555. As for the thoracic aortogram, it depends on the site imaged. My guess is this is a suprvalvular injection (based on ICD9 424.1) and the code for that is 93567. You should verify site of injection (ascending/aortic root vs descending).

HTH


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## la_0922 (Apr 30, 2013)

I agree, however I have seen and heard of Doctors doing RHC based on Valvular diagnoses so the 424.1, and 424.0 would justify the right heart cath. 
The CPT book says that the cath has to cross into the left chambers for LHC -- you can show your doc to inform them of the necessity in order to bill for the LHC.

Louise


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