# Catheterization code help



## kumeena (Nov 19, 2011)

Hello everyone,

I am a student and I would like to know can somebody help me  to code for the  RT/LT heart catheterization?

What are the main terms I should look into the chart?

When to code 93452/93458 for LT heart catheterization?

Thank you


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## johnmeyer (Nov 19, 2011)

Remember.... the biggest thing with catheterization codes is route of entry (i.e. venous or arterial) and final location. Included is the reason for the catheterization.

If you read the two codes you ask about in the CPT book, you'll notice that 93458 is used when the catheter is placed through the coronary artery(s) for cornoary angiography with left heart catheterization. 93452 is used for left heart catheterization when left ventriculography is the reason for the catherterization.

As you go through the cardiovascular section of the CPT, you're going to notice that this is going to be the hardest section to code from. Don't feel bad if you're having a hard time with this. I know coders with as much as 30 years of experience who have a hard time with it.

As far as what to look for in the chart notes..... The cardiovascular section is going to be like any other section. You want to look for action and the reason for the action. After that, just match up the CPT the best you can. I know this isn't much of an explination, but it's much easier for me to explain using actual chart notes.

Hope this helps.


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## krisfelty (Nov 21, 2011)

If a left heart cath was done, you will see that a catheter was in the LV and a Left ventriculogram was done. It will also say that they crossed the aortic valve or gradient across the aortic valve. 
Right heart cath you will see a Swan-Gantz catheter was used or a pulmonary balloon tipped catheter was used and pressures were measured. Sometimes they use a pharmacological agent like inhaled nitric oxide with the right heart cath. 
It is very easy to determine these. If you see LIMA and LAD were injected and patient has previous hx of CABG, you would use the 93459 for a left heart cath with grafts. If it was both rt and lt, use 93461 if they had grafts done also.


Kris Felty, CPC, CCC, CCVTC


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## kumeena (Nov 22, 2011)

Thank you so much. I really appreciate your help.  Now I feel better ( learned something)

Happy Thanksgiving


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