# Cardiac Catheterization



## NESmith (Oct 19, 2012)

I am very new to coding Cardio, Please help me with the coding of this op-report.

Indication: Angina, abnormal nuclear stress test.

Procedure: 1) Left heart catheterization
                 2) Selective coronary arteriography
                 3) Left Ventriculogram, right femoral approach

Left Ventriculogram: Dsiplays grossly normal LV systolic function, normal-appearing left
                               ventricular ejection fraction.
Coronary Arteriography: The left main trunk is patent.

The left anterior descending artery is patent. There is mild calcification, mild luminal irregularities.
There is a high intermediate branch with mild luminal irregularities.
The circumflex artery is patent with mild luminal irregularities small distal vessel. There is probably more significant disease in the distal circumflex distribution, small posterolateral branches nothing discrete.
The right coronary artery is patent, again with mild calcification, mild luminal irregularities.
Discussion: The patient has multiple risk factors for coronary artery disease, had developed recent symptoms and a nuclear stress test that showed attenuation defects with mild reversal bullding. he is obese and part of this must have been some degree of soft tissue attenuation. he does have some diffuse disease and small luminal diameter vessels distally. Risk factor modification and consideration for medical theray will be pursued.

Final Impressions:
1) Coronary artery disease, coronary artery calcification.
a) Patent left main trunk.
b) Patent left anterior descending artery luminal irregularites.
c) Patent circumflex artery, small distal vessel, probably diffusely diseased.
d) Patent dominant right coronary artery, mild luminal irregularities and calcification.
2) Normal left ventricular systolic function, normal appearing left ventricular ejection 
    fraction.
Thank You for anyone help. I am still learning.


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## dpeoples (Oct 19, 2012)

NESmith said:


> I am very new to coding Cardio, Please help me with the coding of this op-report.
> 
> Indication: Angina, abnormal nuclear stress test.
> 
> ...



Unless I missed something, this looks like a plain LHC. I would code 93458

HTH


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## Jim Pawloski (Oct 19, 2012)

dpeoples said:


> Unless I missed something, this looks like a plain LHC. I would code 93458
> 
> HTH



I agree with you Danny!
Jim Pawloski, CIRCC


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## lkprocise (Nov 7, 2012)

*Hearth Cath questions*

I am also new to coding Cardiology.  Can you explain the difference between 93452 and 93458 in layman's terms. Also, are we supposed to aadd Q9966 to every claim. The previous coding/billing company did.

I also have a question regarding 33249 and 33241-51. The previous coder added 93641-26-51 as well to some claims, but not to others saying the same thing?

Thank you for your help!


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## dpeoples (Nov 7, 2012)

lkprocise said:


> I am also new to coding Cardiology.  Can you explain the difference between 93452 and 93458 in layman's terms. Also, are we supposed to aadd Q9966 to every claim. The previous coding/billing company did.
> 
> I also have a question regarding 33249 and 33241-51. The previous coder added 93641-26-51 as well to some claims, but not to others saying the same thing?
> 
> Thank you for your help!



93458 includes coronary angiography
93452 does not

can't speak specifically to the second question, perhaps an error?

HTH


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