# How to code a right heart echo



## 10marty (Nov 27, 2011)

How would you code the following report..

The patient is a 73 year old gentleman who has severe scoliosis and is not a candidate for TEE due to restictive lung disease as well as severe kyphoscoliosis.  He had a previous cardiac cath with step up and proved to be suspicious for possible ASD.

The left femoral vein was accessed where a 9 french sheath was inserted into the vein and an intracardiac echocardiography catheter was carried into the vein and into the right atrium without difficulty under fluoroscopic guidance.  Once we has access to the right atrium, we then performed two-dimensional images from the right atrium as well as color flow and pulse wave doppler.  We performed a saline contrast study to assess the patency of the foramen ovale and after this the probe was then removed and hemostasis was accomplished with manual compression.  

Conclusion: Negative right intracardiac echo for ASD,  There was a patent foramen ovale and an atrial septal aneurysm with RVH and normal LV size and function.


We are having issue with which code to use for the catheter placement.  Thanks for any advise.


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## jewlz0879 (Dec 2, 2011)

I do know that for the External lliac vein cath placement you would use 36012; you might be able to use it for the left femoral as well. 36012 - 'Selective Catheter placement, venous system, second order, or more selective...'


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## krisfelty (Dec 2, 2011)

You would not code a cath placement. This was to assess if the patient had a PFO/ASD. It states a TEE could not be done. So, you would code a right heart cath, 93451-26, 59 and a 93662-26 for the ICE (Intercardiac Echo.) Not sure what place of service this was performed in, but I am assuming either in or outpatient. 

K. Felty, CPC, CCC, CCVTC


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## 10marty (Dec 2, 2011)

Thank you all for your responses.  

Marty


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