Cardiology Coding Alert

Question: My provider made a small incision in the patient’s groin, over the femoral artery, and inserted an introducer sheath into the artery, followed by a guidewire. Under fluoroscopic guidance, they inserted a catheter over the guidewire and sequentially engaged the ostia in the coronary arteries. My provider injected contrast material into the arteries and performed angiograms in multiple views. The provider then inserted the catheter into the patient’s left internal mammary and saphenous vein graft, injected contrast material into the grafts, and performed angiograms in multiple views. They then catheterized the left ventricle and performed a left ventriculogram to measure pressure, volume, and blood flow in the left ventricle. My provider withdrew the catheters, removed all instruments, and applied pressure and a dressing to the wound. They also supervised and interpreted the images obtained during this procedure. What codes should I report for this procedure?

Alabama Subscriber

Answer: Report 93459 (Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography) on your claim.

Don’t miss: Code 93459 includes the coronary and bypass angiography procedure and the associated imaging supervision and interpretation. There may be rare instances 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.