A cardiology coder encountered this particular situation: If he used 93510, 93543, 93545, 93555, and 93556 for a procedure last year, how should he code the same service this year? Well, the final code choice will depend on the documentation of your specific case, however the most likely match based on the codes you list is 93458 (Catheter placement in coronary artery[s] for coronary angiography, inclusive of intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection[s] for left ventriculography, when carried out). Get started here: If you look in the CPT 2011 manual for the codes you used in 2010, you will find instructions to see 93451-93461 and to read the instructions for injection procedures. To find out the proper code for your case this year, look at the services described by the 2010 codes you listed. Left heart catheterization (LHC): Code 93510 (LHC, retrograde, from the brachial artery, axillary artery or femoral artery; percutaneous) was the LHC. As such, the code you select this year needs to include LHC. Imaging and injection procedures: Codes 93543 (Injection procedure during cardiac catheterization; for selective left ventricular or left atrial angiography) and 93545 (… for selective coronary angiography [injection of radiopaque material may be by hand]) were for left chamber and coronary imaging injection procedures. Codes 93555 (Imaging supervision, interpretation and report for injection procedure[s] during cardiac catheterization; ventricular and or atrial angiography) and 93556 (… pulmonary angiography, aortography, and/or selective coronary angiography including venous bypass grafts and arterial conduits [whether native or used in bypass]) represented the S&I portion of the heart as well as coronary imaging. These imaging and S&I services are now included in the same code as the catheterization. This year's injection procedure instructions state," Cardiac catheterization codes (93452-93461), other than those for congenital heart disease, include contrast injection(s) for imaging typically performed during those procedures." Left chamber and coronary imaging fall into that 'typical' category; as such look for a code that includes LHC, left heart imaging and coronary imaging. That code is most probably 93458. For more specialty-specific articles and Q&A to assist yourcardiology coding, sign up for a good medical coding resource like medical Coding Institute.
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