Cardiology Coding Alert

Question: Is there a code for fluoroscopy of the mitral valve with a heart catheterization? The report states, "Fluoroscopy of the mitral valve shows normal mitral valve leaflet motion in multiple views." Codes 71023 and 71034 specify the number of views. Should I use 76000 or is this study included in the catheterization? Can you explain why?

West Virginia Subscriber

Answer: You should use 71023 (Radiologic examination, chest, two views, frontal and lateral; with fluoroscopy) and 71034 (Radiologic examination, chest, complete, minimum of four views; with fluoroscopy) when the physician performs radiological chest exams, with either two views or a minimum of four views. These codes are not appropriate for the fluoroscopy of the mitral valve. Code 76000 (Fluoroscopy [separate procedure], up to one hour physician time, other than 71023 or 71034 [e.g., cardiac fluoroscopy]) is a radiographic technique that provides images of tissues or deep structures of the body by the use of fluoroscopy. This fluoroscopy is usually a component of a more complex procedure and is not identified separately.

And, 76000 is included in the left heart catheterization code 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery;  percutaneous), according to the National Correct Coding Initiative (NCCI). NCCI states that code 76000 has a superscript number 0, indicating that 76000 may never be reported separately with a heart catheterization code.