# Rhc and Lhc



## OPENSHAW (Mar 25, 2013)

Our doctor did the following:

1.) right heart catheterization
2.) selective coronary angiography
3.) aortic root angiography
4.) closure of the right common femoral artery using a #6 french angio- seal device

5.) a lhc was attempted multiple times but unsuccessful.

The patient was on the schedule for a rt and lhc and has severe aortic stenosis. I have attached part of the op report for your review regarding the lhc that was attempted.

The part regarding the lhc in the op report reads as follows:
Thereafter, we performed selective coronary angiography using a jl4 catheter and a jr4 catheter, which demonstrated no occlusive coronary artery disease. Thereafter, we attempted to perform a left heart catheterization initially using a multipurpose catheter followed by a feldman catheter. Multiple attempts to do it under multiple fluoroscopic views were not successful and we abandoned that in favor of obtaining further noninvasive imaging namely possibly a transesophageal echocardiogram to assess the valve area by telemetry. At this time we performed an aortic root angiography that demonstrated mild aortic insufficiency. The diagnosis is 424.1

should i code this as 93456-26, 93458-26-53, 93567. I know that code 93458 bundles to code 93456. The diagnosis is the same which means that code 93458 will prob not get paid.
Or 
93460-26-53, 93567

I do not code for cpt code 75710 since this code bundles.

OR

93460-26-52, 93567

OR SHOULD I BILL 

93456-26-22, W/ MOD 22, OP REPORT REFLECTING TIME COMPONENT, 93567

ANY SUGGESTIONS!


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## ilovemyboys777@yahoo.com (Mar 25, 2013)

wow...that's a good one. 
I would bill 93460-26-53.


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