# Card Cath Question



## cerrigo (Aug 25, 2009)

Our department has a question maybe someone out there can help with. Here it goes:

When coding a cardiac catheterization which includes a coronary angiography, our encoder asks us how many catheters are used, 1, 2, or unknown. Our cath lab is using terminology such as Judkins technique, Seldinger technique, modified-Seldinger technique, etc. 

What are we coding? The technique/approach or the number of catheters used regardless of the approach? (Some are interpreting technique as the number of "sticks" used to gain access to vascular system--some are interpreting technique as the number of catheters used to perform procedure regardless of number of access points.)

I hope this question makes sense. I hope someone can help.


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## rahulasrivastava (Aug 25, 2009)

I have never coded cardiac cath on the basis of number of catheters...what is important is the approach/technique. In fact, the section notes of the heart cath codes in the CPT states catheter(s) - which means one or more catheter. Still I would welcome some more thoughts !!


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## cerrigo (Aug 25, 2009)

The CPT code for coronary angiogram isn't the problem--our problem is with the ICD-9 code for the coronary angiogram.  88.55 is Coronary Angiogram using a single catheter, 88.56 is Coronary Angiogram using two catheters, and 88.57 is Other.   This is were the confusion is coming from.


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## vikas.maheshwari (Aug 26, 2009)

the Cardiac Cather normally contain 3 catheter

Judkins L (JL) for left sided artery i.e. LAD and LCX
Judkins R (JR) for RCA
Pigtail catheter for LV angiogram


Some times the cardiologist unable to hook the arteries with these normal catheter then he tries different catheter i.e. AR1 and AR2, AL1 and AL2, MP, so it's totally depend on the patient coronary artery structure.


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## rahulasrivastava (Aug 26, 2009)

this info is great...


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