Cardiology Coding Alert

Question: One of our cardiologists performed a left heart catheterization with left ventriculography, cors imaging, aortocoronary venous bypass imaging, arterial conduits (left internal mammary artery [LIMA]) and aortography. He is reporting only 93556 for imaging of the aortic root during aortography. If the aortography wasn't selectively visualized, can I also report 93544? Michigan Subscriber Answer: From the information you provide, the cardiologist appears to have performed a nonselective aortography. If the physician performed the aortography during a heart catheterization, the procedure would include the area from the aortic root up to the arch. If he or she did the aortography selectively, you can report 93544 (Injection procedure during cardiac catheterization; for aortography). Don't forget to report the other relevant procedure codes. For the left heart catheterization, you should report 93510 (Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous). Use 93543 (Injection procedure during cardiac catheterization; for selective left ventricular or left atrial angiography) for the left ventriculography.

For the coronary angiogram imaging, use 93545 ( for selective coronary angiography). To report the aortocoronary venous bypass imaging, bill 93540 ( for selective opacification of aortocoronary venous bypass grafts, one or more coronary arteries). For the injection of the LIMA, report 93539 (... for selective opacification of arterial conduits [e.g., internal mammary], whether native or used for bypass). For the supervision and imaging of the ventriculogram, report 93555 (Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; ventricular and/or atrial angiography) and append modifier -26 (Professional component). Report 93556 (... pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]) for the aortography of the bypass graft.