Cardiology Coding Alert

Question: The patient has a congenital heart defect, an isolated atrial septal defect, and normal native connections. My cardiologist made a small incision in the patient’s arm to access the target vessel and introduce a catheter. Using fluoroscopy, my cardiologist advanced the catheter via the blood vessels to the target zone of the right heart. They placed the catheter in the right atrium and used the catheter to obtain blood samples to measure blood gases. This included Fick cardiac output measurements. To complete the procedure, my cardiologist removed the catheter and applied pressure at the access site. Which code should I report for this procedure?

California Subscriber

Answer: You should report 93593 (Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections).

CPT^® provides several codes for congenital cardiac catheterizations. So, you should review the descriptors and guidelines carefully to determine the appropriate code. Code 93593 is specific to right heart catheterization (RHC) in a patient with one or more congenital heart defects. Additionally, code 93593 is specific to RHC in a patient with normal native connections, which means that the blood flow follows the expected course through the heart chambers and great vessels, from the superior/inferior vena cava to the right atrium, right ventricle, and pulmonary arteries for the right heart.

Don’t miss: Right heart structures typically supply blood flow to the pulmonary artery.