# Opinion Please Coronary angiogram



## MMillercpc (Sep 10, 2009)

The documentation is vague and I don't normally code these procedures.. 

The report states " introducer was placed in the right femoral artery. Cornary angiography was carried out in the standard manner using a 6 french left-4 judkins catheter and 6 french right -4 judkins catheter. Left ventriculogram was perfomed in RAO projection using 30 cc optiray at 12 cc/sec. Following ventriculogram, all the catheters were removed and patient left the lab in good condition"

My question is... because it indicates a left and right french catheters I am assuming both right and left were catheterized? I would code 93526? Would I code for the ventriculogram?

Im thinking 

93526
93545
93556

again I am completely new to this so any suggestions at all would help!!


----------



## Jim Pawloski (Sep 10, 2009)

Jiggers01 said:


> The documentation is vague and I don't normally code these procedures..
> 
> The report states " introducer was placed in the right femoral artery. Cornary angiography was carried out in the standard manner using a 6 french left-4 judkins catheter and 6 french right -4 judkins catheter. Left ventriculogram was perfomed in RAO projection using 30 cc optiray at 12 cc/sec. Following ventriculogram, all the catheters were removed and patient left the lab in good condition"
> 
> ...



As to the Judkins catheters, these catheters are pre-shaped by the factory to be used for coronary catheterization.  Judkins is the person who designed the catheter (I believe he is a Cardiologist).  The report does state that the coronaries were catheterized, and I hope there was an interpretation of the coronaries so they can be coded.  So for your codes, you have 93510 , lt heart catheterization, 93545 - for injection of coronaries, 93543 - injection of LV, 93555 S&I of LV, 93556, S&I of coronary vessles.

Hope that helps you out!
Jim Pawloski  CIRCC


----------



## MMillercpc (Sep 10, 2009)

*Wow!*

 Geez I was just a little bit off! Thank you so much. So I would use both 93555 for the ventriculography and 93556 for the coronary angiogram portion?


----------



## dpeoples (Sep 11, 2009)

Jiggers01 said:


> Geez I was just a little bit off! Thank you so much. So I would use both 93555 for the ventriculography and 93556 for the coronary angiogram portion?




That is correct. I completely agree with the codes Jim gave but would stress that an interpretation is necessary to bill for 93543,93545,93555,93556. I too hope there is more documentation than you gave.

Also, a Right Heart Cath and selection of the right coronary artery (for injection) are not the same thing. A RHC is performed through a venous access, which is not documented, therefore only 93510 should be coded.

HTH


----------



## MMillercpc (Sep 17, 2009)

*This is the entire report....*

Procedure: The patient received 25 mg Benadryl, 2 mg Valium intravenously.
The right groin was prepped and draped in standard manner with 1% Lidocaine.
The right femoral artery was punctured using 18-gauge thin-walled needle and a
#6 catheter introducer placed in the right femoral artery using Seldinger
technique. Coronary angiography was carried out in the standard manner using
a 6 French left-4 Judkins catheter and 6 French right-4 Judkins catheter. Left
ventriculogram was performed in RAO projection using 30cc Optiray at 12
cc/sec. Following the ventriculogram, all the catheters and sheaths were
removed and the patient left the catheterization lab in good condition without
apparent complication.


----------

