Wiki LIMA angio documentation

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jtb57chevy

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When you have a physician that does a selective LIMA angio that reveals no stenosis, can you automatically assume he /she is doing it to evaluate for bypass grafts? I have a couple of cases where it is evident to me that that is the rationale, but the physician doesn't come right out and say why the LIMA is being angio'd, just that it was and what the result of the angio was, i.e. "LIMA is patent". In the recommendations it will be stated that the patient will be evaluated for bypass by the surgeons, but no direct correlation is made.

So do you stick with the 93454/93458 or make the assumption and use the 93455/93459?

I just really am reluctant to "assume" anything.

Any thoughts on this?
 
jtb57chevy said:
When you have a physician that does a selective LIMA angio that reveals no stenosis, can you automatically assume he /she is doing it to evaluate for bypass grafts? I have a couple of cases where it is evident to me that that is the rationale, but the physician doesn't come right out and say why the LIMA is being angio'd, just that it was and what the result of the angio was, i.e. "LIMA is patent". In the recommendations it will be stated that the patient will be evaluated for bypass by the surgeons, but no direct correlation is made.

So do you stick with the 93454/93458 or make the assumption and use the 93455/93459?

I just really am reluctant to "assume" anything.

Any thoughts on this?
Click to expand...

I think you may be over analysing this. It really isn't an assumption if you have documentation in the medical record (by the surgeon) that the patient is being evaluated for bypass. A coronary angiography including "potential" bypass artery candidates is a routine procedure in a bypass eval. Just because your provider fails to include this information does not mean that information does not apply. Besides, there are no other codes that you could use for an injection of the LIMA when performed with a coronary angiography.

HTH :)
 
Thanks Danny! I agree that I was totally over analyzing the thing :)
Your answer makes perfect sense.
 
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