# Angiography



## Melonyw (Apr 30, 2009)

Here is another I would like help with please!! Sry for all the posts just trying to learn 

Angiography

Access was made in the right femoral artery.

The cath was passed over a guidewire through the sheath in the groin, up and over and around the aortic arch to just above the left main coronary artery where the guidwire was removed and pressures were obtained, and then the cath was gently placed into the left main coronary artery. Multiplane injection of contrast was recorded. The cath was placed in the ostium of the right coronary artery where multiple views were taken.  A pigtail cath was placed inside the left ventricle. The lft ventricular end diastolic pressure was recorded, and left ventriculogram was performed, after which the pressure was then again recorded and pullback was recorded across the aortic valve. The LIMA graft to the LAD was than viewed. The SVG to the diagonal was viewed.

The goin access site then underwent angiography through the femoral arterial sheath.


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## jtuominen (May 1, 2009)

I would code this as:

93510: Left heart Cath (catheter entered the left ventricle)

93545: coronary angiography
93556: RS&I for the coronary angiography

93543: left ventriculogram
93555: RS&I for the left ventriculogram

And as long as you can find documentation that the LIMA Graft and SVG graft were selectively engaged, I would code:

93539: LIMA angiogram
93540: SVG angiogram

I don't think with what you have documented above that I would be comfortable coding a 93544 for an aortography, because the doc never explicitly states he performed an aortography and I believe it is possible to obtain pressures from the the catheter without angiography. Maybe there are additional thoughts on this last code out there?

Hope this was helpful,

Jayna, RHIA


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## ebarnett (May 1, 2009)

*cardiology*

I agree with Melonyw except you need to code 93556 instead of 93555 2 times.


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## jtuominen (May 4, 2009)

whoops yep 93556 the second time. sorry hope I didn't add to any confusion!


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## Melonyw (May 12, 2009)

Thank you so much for helping me It means alot for you all to let me use you all for information  I want to learn but I look at the codes so much and read a op report over and over again I think I confuse myself. I know it can only get better with everyones help. I really really do appreciate it.


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