# New to cath coding - confused



## kmac (Mar 9, 2011)

Hello! I am hoping someone could shed some light for me on coding this procedure. I am new to coding cath's and have tried to understand on my own using references & diagrams, but not getting the abd. aortogram part. I code for facility and we just opened cath lab.
The proc.'s done are Rt&Lt heart cath, lt. ventriculogram, bilat.coronary arteriography, abd. aortogram & selective arteriogram of bilat iliofem. I understand the heart cath, ventriculograms & coronaries. Dr's description of abd. aortogram is "...a lt ventriculogram was performed injecting 36cc of contrast. Pullback pressures were recorded . The pigtail cath was then lowered down just above the bifurcation of the aorta and an abd. aortogram was done injecting 30cc of contrast. The pigtail cath was then replaced w/ a #5French selective lt. coronary catheter and then advanced to the root of the aorta and into the lt. main coronary artery. The lt. coronary circulation was visualized w/ contrast injections. Cath was replaced w/ selective rt. coronary cath and injected and visualized. The cath was replaced w/ a Reamer cath and advanced over to Lt. common iliac artery. The lt. iliofemoral popliteal system was then visualized, injecting 30cc of contrast selectively into the lt. common iliac. The reamer was then removed and the rt. iliofemoral & popliteal system was visualized injecting 30cc of contrast via arterial sheath."
CPT's I chose are 93460, 93567 & 36245. Not sure about the 93567 b/c it says "supravalvular" or would abd. aortogram be inclusive of the heart cath? Not certain about the 36245 either. Please help!


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## dpeoples (Mar 9, 2011)

kmac said:


> Hello! I am hoping someone could shed some light for me on coding this procedure. I am new to coding cath's and have tried to understand on my own using references & diagrams, but not getting the abd. aortogram part. I code for facility and we just opened cath lab.
> The proc.'s done are Rt&Lt heart cath, lt. ventriculogram, bilat.coronary arteriography, abd. aortogram & selective arteriogram of bilat iliofem. I understand the heart cath, ventriculograms & coronaries. Dr's description of abd. aortogram is "...a lt ventriculogram was performed injecting 36cc of contrast. Pullback pressures were recorded . The pigtail cath was then lowered down just above the bifurcation of the aorta and an abd. aortogram was done injecting 30cc of contrast. The pigtail cath was then replaced w/ a #5French selective lt. coronary catheter and then advanced to the root of the aorta and into the lt. main coronary artery. The lt. coronary circulation was visualized w/ contrast injections. Cath was replaced w/ selective rt. coronary cath and injected and visualized. The cath was replaced w/ a Reamer cath and advanced over to Lt. common iliac artery. The lt. iliofemoral popliteal system was then visualized, injecting 30cc of contrast selectively into the lt. common iliac. The reamer was then removed and the rt. iliofemoral & popliteal system was visualized injecting 30cc of contrast via arterial sheath."
> CPT's I chose are 93460, 93567 & 36245. Not sure about the 93567 b/c it says "supravalvular" or would abd. aortogram be inclusive of the heart cath? Not certain about the 36245 either. Please help!



I agree with your code choices, including 93567 for the supravalvular aortic root injection, assuming the report includes findings for each of those injections.
Whether or not to code for the abdominal and iliofemoral angiography (G0275/G0278 or 75625/75716) really depends on the documentation of medical necessity (for those specific procedures) and the independent interpretation (report) for those specific procedures.

Both criteria should be met, otherwise they could be considered guidance and are included in the services for the heart catheterization.

HTH


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## kmac (Mar 9, 2011)

Thanks!


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