You Be the Coder:
Coronary Angiography
Published on Thu Nov 01, 2001
Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: A catheter was placed into the coronary sinus. Hand injections of contrast demonstrated a dilated coronary sinus. Hand injection contrast from the left arm was also administered and demonstrated very slow flow but apparent persistent left superior vena cava. Is this just coronary angiography? Should it be coded 93545 and 93556-26?
Florida Subscriber
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Answer: Depending on the documentation, it may not even qualify as payable coronary angiography. When placing leads to the coronary sinus (for example, during an EP study), cardiologists may inject dye to guide them to the correct location. Angiography performed for localization is not separately payable because it is not considered medically necessary.
If the cardiologist documented another reason why angiography was performed, angiography may be reported separately. Cardiac catheterization codes (such as 93545 and 93556) should not be used, because a heart cath has not taken place. Instead, use 36005 (injection procedure for contrast venography) for the injection and 75860 (venography, sinus or jugular, catheter, radiological supervision and interpretation) for the radiology component.
Note: Venography codes are used because the coronary sinus is a venous structure that empties into a right-sided heart chamber. | |
