Cardiology Coding Alert

Question: Once the patient was prepped and anesthetized, my cardiologist made a small incision in the groin. They inserted an introducer sheath into the femoral artery, followed by a guidewire. Under fluoroscopic guidance, my cardiologist inserted left and right catheters over the guidewire and sequentially engaged the ostia in the coronary arteries. They injected contrast material through the catheters and performed angiograms in multiple views. My cardiologist introduced a catheter into the pulmonary artery to measure pressure, volume, and blood flow in the right side of the heart. They then performed a left ventriculogram to measure pressure, volume, and blood flow in the left ventricle. My cardiologist withdrew the catheters, removed all instruments, and applied pressure and a dressing to the wound. They supervised and interpreted the images obtained during this procedure. How should I report this?

North Carolina Subscriber

Answer: Report 93460 (Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed) for this procedure.

Don’t miss: Code 93460 includes the coronary angiography procedure and the associated imaging supervision and interpretation.

There may be rare cases where one provider supervises the radiology service and another provider interprets it. According to Medicare guidelines, each provider should report the radiology code and append modifier 52 (Reduced services). Each should also append modifier 26 (Professional component) to the code to report only the professional component.

Meagan Williford, BA, MA, CPC, Contributing Writer