# LHC w/coro inj. only - Help



## peeya (Feb 22, 2011)

Can some one please help. I have looked at all the resources available for the new cath codes that were posted but am still not sure about this. What is the CPT code that can be used when the Doctor just does:

1. Left heart catheterization.
2. Selective left main coronary angiography.
3. Supervision and interpretation of coronary angiography

Left ventriculography was not done. Can we still bill with 93458? 

Please help.


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## theresa.dix@tennova.com (Feb 23, 2011)

peeya said:


> Can some one please help. I have looked at all the resources available for the new cath codes that were posted but am still not sure about this. What is the CPT code that can be used when the Doctor just does:
> 
> 1. Left heart catheterization.
> 2. Selective left main coronary angiography.
> ...




 The criteria for coding a left heart cath which is 93458 is not the Left Ventriculography. it is whether the aortic valve was crossed so look in the report for indications of this!. Itracardiac pressures etc. Let me know what you find


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## theresa.dix@tennova.com (Feb 23, 2011)

peeya said:


> Can some one please help. I have looked at all the resources available for the new cath codes that were posted but am still not sure about this. What is the CPT code that can be used when the Doctor just does:
> 
> 1. Left heart catheterization.
> 2. Selective left main coronary angiography.
> ...




 The criteria for coding a left heart cath which is 93458 is not the Left Ventriculography. it is whether the aortic valve was crossed so look in the report for indications of this!. Itracardiac pressures etc. Let me know what you find


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## peeya (Feb 24, 2011)

DESCRIPTION OF THE PROCEDURE: Following informed consent, the
patient was brought to the cardiac catheterization laboratory where
the right groin was prepped in usual sterile fashion. Then, 8 mL of
1% Xylocaine was infiltrated in the right groin for local anesthesia.
A 6-French sheath was introduced in the right femoral artery using
the modified Seldinger technique upon first attempt.
A 6-French JL4 and a 6-French JR4 catheter was used for selective
left and right coronary angiography respectively. Subsequently, a
pigtail catheter was advanced to the left ventricle where pressure
measurements were obtained. No cineventriculography was performed in
order to save contrast dye. Subsequently, all catheters were removed
as was the sheath, and manual pressure was applied until good
hemostasis was obtained. There were no complications during the
procedure. The total amount of contrast used was 50 mL. Total fluoro
time was 3.3 minutes.
HEMODYNAMICS
1. Opening aortic pressure is 115/68/91.
2. Left ventricular pressure is 122/14 with left ventricular enddiastolic
pressure of 20 mmHg.
3. There was no gradient on pullback of the pigtail catheter from the
left ventricle in the ascending aorta.
4. Final aortic pressure is 126/77/98.

Here is the description of the procedure. It seems that the aortic valve was crossed. So is it ok to bill the 93458?


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## Jess1125 (Feb 24, 2011)

Yes, this would be 93458-26

Jessica CPC, CCC


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