# left heart cath-As long as pressures



## sheri_hall2000@yahoo.com (Jul 12, 2012)

As long as pressures were done in the LV, you can bill 93458, even without the ventriculogram.


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## Cyndi113 (Jul 12, 2012)

93454 is coronary angiography. 93458 is coronary angiography and LHC.


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## Jim Pawloski (Jul 24, 2012)

mdunn said:


> Seems as though everyone has totally answered everything but my actual question. I want to know if you still code  93458 if the ventriculogram is not performed, but the aortic valve is crossed. NO PRESSURES were measured, no ventriculogram.



If no LVgram performed or no pressures were taken, then no LHC.  You have just an Coronary angiography.  
HTH,
Jim Pawloski, CIRCC


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## dpeoples (Jul 24, 2012)

Jim Pawloski said:


> If no LVgram performed or no pressures were taken, then no LHC.  You have just an Coronary angiography.
> HTH,
> Jim Pawloski, CIRCC



I agree with Jim.

HTH


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## Jim Pawloski (Jul 24, 2012)

dpeoples said:


> I agree with Jim.
> 
> HTH



Thanks Danny, good to hear from you!

Jim Pawloski,
CIRCC


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## Misty Dawn (Jul 25, 2012)

Jim Pawloski said:


> If no LVgram performed or no pressures were taken, then no LHC.  You have just an Coronary angiography.
> HTH,
> Jim Pawloski, CIRCC



I am confused.  The left heart cath codes are defined as "with or without LVgram" but your are saying the LVgram must be performed to bill on Left HTC?


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## jewlz0879 (Jul 26, 2012)

Jim Pawloski said:


> If no LVgram performed or no pressures were taken, then no LHC.  You have just an Coronary angiography.
> HTH,
> Jim Pawloski, CIRCC



Jim, 

Thank you so very much for this clarification. When I first started Cardio coding I was told that, "as long as the physician crosses the aortic valve, you have a LHC." I'm glad to have been set straight.


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## dpeoples (Jul 26, 2012)

Misty Dawn said:


> I am confused.  The left heart cath codes are defined as "with or without LVgram" but your are saying the LVgram must be performed to bill on Left HTC?



Misty,
It is primarily the left ventricular pressures that must be documented. Certainly if a left ventriculogram is documented you have a LHC. It is when there is no left v'gram that the question arises. In the age of cut and paste or canned documentation, just stating the aortic valve was crossed is not enough IMO. 

HTH


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## dpeoples (Jul 26, 2012)

mdunn said:


> What determines whether to bill 93454 or 93458. In the dictation the physician states "the aortic vavle was cross", but the ventriculogram was not performed. The nurses that enter the charges believe this is 93454 because there was no ventriculogram, but I feel it is still 93458(left heart cath) because the aortic valve was crossed. Code 93458 states "ventriculogram, when performed".



from Zhealth Diagnostic and Interventional Cardiovascular Coding Reference 2011

"Documentation of pressures in the right heart or left heart chambers is necessary to submit a "heart cath" code for one of these procedures"...




also, don't forget about 93452...LHC w/o coronary angiography

HTH


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