Cardiology Coding Alert

Question: For LHC with a left ventriculography and angiography of the LCX, LAD, and RCA, should I report 93556 once or three times?

Georgia Subscriber

Answer: Even though the cardiologist obtained angiograms of three coronary arteries, you may only report one unit of 93556 (Imaging supervision, interpretation and report for injection procedure[s] during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]).

Support: CPT Assistant (1994) indicates that "Code 93556 is reported only once, no matter how many of the described angiograms are performed."

Additional codes: Don't forget to report all of the codes appropriate for this left heart catheterization (LHC), appending modifier 26 (Professional component) to those codes with both professional and technical components:

• 93510-26 -- Left heart catheterization, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous
• 93543 -- Injection procedure during cardiac catheterization; for selective left ventricular or left atrial angiography
• 93545 -- Injection procedure during cardiac catheterization; for selective coronary angiography (injection of radiopaque material may be by hand)
• 93555-26 -- Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; ventricular and/or atrial angiography
• 93556-26 -- Imaging supervision, interpretation and report for injection procedure(s) during cardiac catheterization; pulmonary angiography, aortography, and/or selective coronary angiography including venousbypass grafts and arterial conduits (whether native or used in bypass).

-- Coding expertise for this issue provided by Christina Neighbors, MA, CPC, CCC, ACS-CA, charge capture reconciliation specialist and coder at St. Joseph Heart & Vascular Center in Tacoma, Wash., and member of the AAPC's Certified Cardiology Coder steering committee.