# RT/LT heart cath



## csorensen21@yahoo.com (Jun 26, 2013)

Procedure: Right and left heart catherization

Indication: Worsening shortness of breath with evidence suggestive of sever aortic stenosis on echocardiography.

Description of Procedure: The patient was taken to the cath lab. The right groin was prepped and draped in the usual manner and was anesthetized with 1% lidocaine. A 6-french sheath was placed in the right femoral artery using a modified Seldinger technique without any difficulty. Similarly, a 7-French sheath was placed in the right femoral vein. Right heart catherization was performed using a 7-French Swan-Ganz catheter. I then used a 6-French multipurpose catheter and was able to get access into the left ventricle using a regular J-wire. Left ventriculography was performed in the RAO projection with multipurpose catheter in the left ventricle with several mL of contrast using hand injection. Several minutes later, I performed a left ventricular aortic pullback and then proceeded with measurement of cardiac outputs using the thermodilution technique. Subsequently, I proceeded with left and then right coronary angiography using 6-French JL4 and JR4 catheters. Finally, both sheaths wee removed and hemostasis to the right arterial side was achieved using the Mynx device. The patient tolerated the procedure well and left the cath lab in stable condition.

I'm not sure what codes to use in this situation. I could use some help! Can I bill code 93561 and 93503 in addition to the RT/LT heart cath? 

Thank you!

Carrie Sorensen, CPC


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## jewlz0879 (Jun 26, 2013)

I would code 93460-26 but would not capture 93561 (since it can't be billed with 93451-93462) or the 93503. 

HTH


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## Tcarmany (Jan 31, 2014)

*Right heart cath w/rt & lt coronary angiography*

PLrocedure: Right heart Cath w/angiography of L Main, LAD, Ramus, LC, and RCA. The plhysician did not cross the aortic valve into the left ventricle. 

We have been experiencing questions regarding this being a left & rifht heart cath. I code as a right heart cath w/coronary angiography of the above arteries being viewed.
Please review and let me know if this is correct, or should it be a left and right heart cath.
Thank you.

Trudy A. Carmany, CPC
Good Samaritan Hospital
HIMS Department
gcarmany@gshleb.org


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## Jess1125 (Feb 3, 2014)

Tcarmany said:


> PLrocedure: Right heart Cath w/angiography of L Main, LAD, Ramus, LC, and RCA. The plhysician did not cross the aortic valve into the left ventricle.
> 
> We have been experiencing questions regarding this being a left & rifht heart cath. I code as a right heart cath w/coronary angiography of the above arteries being viewed.
> Please review and let me know if this is correct, or should it be a left and right heart cath.
> ...



I would agree with you. If the aortic valve wasn't crossed you don't have a LHC and just have right heart cath/coronaries.

Jessica CPC, CCC


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## OPENSHAW (Feb 4, 2014)

I would use 93460-26.  

Thank you!!!!


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