93451 or 93456 (with 93568). Does selective imaging imply the coronary angiography?

[Stephanie Hunt]

75-year-old patient with worsening shortness of breath and chest pain. Via a right brachial access, the catheter is advanced to the left coronary artery with selective imaging of the left anterior descending and left circumflex arteries. The catheter is then placed in the right coronary artery. The right coronary artery is normal. The left ventricle could not be entered due to the presence of a mechanical valve replacement. A flow directed catheter is then advanced into the right ventricle, right atrium and pulmonary artery, with wedge pressure performed. Contrast is selectively injected in the main pulmonary artery with angiography performed. The catheter is removed and pressure held for hemostasis.

Does the term selective imaging imply the coronary angiography?

93451, with 93568?

OR

93456, with 93568?

Thank you!

 

[Jim Pawloski]

75-year-old patient with worsening shortness of breath and chest pain. Via a right brachial access, the catheter is advanced to the left coronary artery with selective imaging of the left anterior descending and left circumflex arteries. The catheter is then placed in the right coronary artery. The right coronary artery is normal. The left ventricle could not be entered due to the presence of a mechanical valve replacement. A flow directed catheter is then advanced into the right ventricle, right atrium and pulmonary artery, with wedge pressure performed. Contrast is selectively injected in the main pulmonary artery with angiography performed. The catheter is removed and pressure held for hemostasis.

Does the term selective imaging imply the coronary angiography?

93451, with 93568?

OR

93456, with 93568?

Thank you!

I see 93456 - Coronary angio. w/ Right heart cath, but there are not results of the pulmonary angio documented.