Cardiac catheterization is a procedure that allows the doctor to see how well your blood vessels supply your heart. This process is used to diagnose and treat certain cardiovascular conditions.
During this procedure, a catheter (long thin tube) is inserted in an artery or vein in your groin, neck, or arm and threaded through your blood vessels to your heart.
Let’s look at the technical component is covered under Part A for cardiac catheterization:
CPT codes for cardiac catheterization
CPT codes 93452-93461 for Cardiac catheterization include various measures such as image supervision, contrast injections, interpretation, and report for imaging.
Let’s look at some CPT codes in detail:
- CPT code 93451 – Right heart catheterization
- CPT code 93452 – Left Heart Catheterization
- CPT code 93453 – Right and left heart catheterization
- CPT code 93454 – Coronary Angiography Only
- CPT code 93455 – Coronary and Bypass Angiography
- CPT code 93456 – Coronary angiography along with right heart catheterization
- CPT code 93457 – Coronary angiography and bypass grafts, along with right heart catheterization
- CPT code 93458 – Left Heart Catheterization with Coronaries
- CPT code 93459 – Left Heart Catheterization along with Coronaries and Bypass
- CPT code 93460 – Coronary angiography with right and left heart catheterization
- CPT code 93461 – Coronary angiography with bypass grafts along with right and left heart catheterization
However, some cardiac catheterization procedures need preauthorization which includes 93452, 93453, 93454, 93455, 93456, 93457, 93458, 93459, 93460, and 93461 CPT codes.
Correct add-on codes getting paid if authorization for one of the codes listed above have done. Moreover, These Add-on codes need not require preauthorization, as well as these Add-on codes, may be used with other procedures. Moreover, some services are also included in cardiac catheterization for the above codes.
Following Services are included in cardiac catheterization procedures
- Local anesthesia and/or sedation
- Introduction, positioning, and repositioning of catheters
- Recording of intracardiac and intravascular pressures
- Obtaining blood samples for blood gases
- Cardiac output measurements
- Monitoring service which including oxygen saturation, ECCS, arterial pressures
- Vascular catheter and line removal
- Final Evaluation
- Written Report
When a catheter is placed in the right heart for medically necessary monitoring purposes, the code 93503 must be reported. The codes describing a right heart catheterization (e.g., 93451) are used only for medically necessary diagnostic procedures.
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Code 93503 includes:
- Anesthesia or sedation.
- The insertion of the flow-directed catheter.
- The recording of intracardiac and intravascular pressures.
- Obtaining blood samples.
- The use of data obtained from measurements of the catheter.
Moreover, Endomyocardial biopsy (93505) may be separately allowed when performed independently or in addition to a cardiac catheterization procedure, when medical necessity is met, for instance, pre or post heart or heart/lung transplant, suspected doxorubicin myotoxicity, in the presence of, or suspected heart neoplasm. While billing for this service, you can list one unit of service for single or multiple biopsy excisions.
Let’s look at the professional component is covered under Part B for cardiac catheterization:
Cardiac catheterizations under Part B can be performed in the following place of service (POS):
Professional and /or technical services are payable in an:
- 11-Office,
- 49-Independent clinic
Professional service is payable in:
- 21-inpatient,
- 22-outpatient
Cardiac catheterizations will be payable:
- 06-Cardiology,
- 78-Cardiac Surgery
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