# Pediatric Cardiology Help



## Rhonda L Stewart (Jan 23, 2012)

Can anyone help me with coding the heart cath for a patient (baby) with hypoplastic left heart syndrome?  The report does not document retrograde or transeptal heart cath.  The baby has a single systemic ventricle.  There is no mention of Left Atrium, Left Ventricle, Mitral Valve, Aortic Valve.  The physician want to report a CPT 93531 - Right/Left Heart Cath Retrograde??  All documentation pertains to SVC, Right Ventricle, Pulmonary Veins, Pulmonary Arteries, Aortic Root, Descending Aorta.  We are currently disagreeing on this heart cath. Not much help out there for Pediatric Cardiology.  Thanks!


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## Cyndi113 (Jan 23, 2012)

Rhonda, 

Would you post the procedural note. It is easier to offer an opinion if I read the actual note.

Thanks,


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## Rhonda L Stewart (Jan 31, 2012)

*Pediatric Cardiology note-Hypoplastic Left Heart Syndrome*

Body of the Report Reads:

A right and left heart cath was then performed by advancing a pigtail catheter through the arterial sheath to the descending aorta and a balloon wedge catheter to both superior vena cava, all four pulmonary veins, right atrium, right ventricle with hemodynamic data obtained in the DAO, RSVC, LSVC, RUPV, RLPV, LUPV, LLPV, RA, RV.  There was great difficulty in advancing the balloon wedge catheter to the pulmonary artery position, so a Cobra catheter was exchanged and advanced to the right pulmonary artery position.  We elected not to cross to the left pulmonary artery because there was a stent already placed.  Angiography was performed in the RSVC, LSVC, all four Pulmonary veins, RPA and Aortic Root.  

This is the body of the cath report.  The CPT for Congenital Cardiology Right and Left Heart Cath performed was CPT 93531.  I personally tried to change it to a Right Heart Cath only Congenital CPT 93530.  Physician argued and stated the patient is Hypoplastic Left heart which means he only has one systemic ventricle with the right ventricle doing all the work.  She thinks because she engaged the 4 pulmonary veins this would still consider this a Retrograde Right/Left Heart Cath Congenital CPT 93531.

Thanks for your help,
Rhonda L Stewart CPC, CCC


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