# In urgent need for a Cardiac Cath Coder



## PbiLinda (May 26, 2009)

If the physician performs a complete left heart cath (93510, 93543, 93555, 93556) then in the report he states that he has evaluated the RIGHT ATRIUM, can I Bill code:  93501 with 93510 or do I bill code (93526, 93543, 93555 and 93556).

I really appreciate if any one can help me on this coding situation, since this is the first time my cardiologist reports like this.

Thank you very much,

Linda


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## jtuominen (May 26, 2009)

Hi Linda--

I guess to be sure we could use a little more information. Did the doctor position a second catheter through the femoral vein and did he thread it up into the right heart from there along with the catheter he used for his/her left heart cath? If so then you may have a case for a 93526 (a right and left heart cath). When you say he "evaluated" the right atrium, do you mean he or she just grabbed some pressure readings, or did they do right atrial angiography or right ventriculgraphy as well (this would mean they injected contrast into the right heart, adn then you can code a 93542 additionally)

So here are three possible sceanrios that I think may apply to your situation:

Doctor uses two catheters to perform a right (to obtain right heart pressures and perhaps some pulomnary wedge pressures) and left heart cath, with left ventriculography, and coronary angiography:
93526
93543
93545
93555
93556

Or
Doctor uses two catheters to perform a right (to obtain right heart pressures and perhaps some pulomnary wedge pressures) and left heart cath, with left ventriculography, and coronary angiography, AND right atrial angiography or right ventriculography:

93526
93542
93543
93545
93555
93556

Or
Doctor uses one catheter to perform a left heart catheterization, left ventriculogram, and coronary angiography, and then accesses the right heart to do a right atrial or ventricular angiography with that single catheter (perhaps through a septal opening? trying to think of a possible scenario?):
93510
93542
93543
93555
93556

I cannot think of an instance when you would code 93501 and 93510 together. I believe if you did try to assign them together you would run into an unbundling edit. 93526 would be the correct way to report a left and a right heart cath done during one single visit.

Hope this is helpful. Perhaps someone else will have some thoughts too.


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## FTessaBartels (May 26, 2009)

*OR ... was there a typo?*

Just be sure that the "right" wasn't a typo (it happens) ...

F Tessa Bartels, CPC, CEMC


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## jtuominen (May 27, 2009)

haha! That too!


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