# heart cath and carotid angio??



## codiologist (Sep 20, 2009)

Hi,
Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together? 

A complete left heart cath w/imaging and inj proc....

Bilateral Common Carotid angio and a left subclavian angio.

This is what I thought??

36216 RT     -  Com Carotid  Cath placement 
36215 LT      - Com Carotid  Cath placement
36215 59 LT  - Subclavian    Cath placement
75680 26      - Bilateral Carotid  angio
75685 26  59 -  Left Subclavian  angio
93510 26 51   - LT Heart Cath
93545 59       - Coronary Angio injection
93543 59      - Lt Vent Angio (he did cross the Aortic Valve) injection
93556 26 59  - Lt and Rt Coronary Angio
93555 26 59 -  Lt Vent Angio

Am I even close??

Thanks, MB Coder


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## deeva456 (Sep 21, 2009)

01048111 said:


> Hi,
> Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together?
> 
> A complete left heart cath w/imaging and inj proc....
> ...



Hello,

W/o reading the report and assuming catheter placements and injections were properly documented I would agree with your codes;however I would not add modifier 59 to the heart cath codes. Most commonly, the heart cath is performed first then catheters are exchanged and then placed in the carotids and subclavian.  If the heart cath was done following the carotid angio then it would be appropriate to add modifier 51 and 59 to the heart cath codes.  Does this make sense?  

good luck!

Dolores, CPC, CCC


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## dpeoples (Sep 24, 2009)

01048111 said:


> Hi,
> Can anyone help me out please? How would I code for a left heart cath and a carotid angio when performed together?
> 
> A complete left heart cath w/imaging and inj proc....
> ...



Without seeing the report the codes look alright with the following exceptions:

You will probably need to add modifier 59 to both 36215 codes as they will bundle into 36216.
The LT Subclavian angio is 75710 unless the doc is reading the LT Vertebral.
Also, if the LT Subclavian is to evaluate the LIMA, then you should not code a 75710 or 75685 but instead should code 93539, and drop the selective catheter placement to the LT Subclavian.

You should not need modfier 59 for the other codes.

HTH


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## codiologist (Sep 30, 2009)

Thanks everyone for your response. I billed the claim the way I had mentioned. I will continue to review this site for anymore replies if it come back denied.

Thanks, MB Coder - CPC


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