Codes Discussed: 93505 (Endomyocardial biopsy), 93451-XU (Right heart catheterization with oxygen saturation and cardiac output, separately identifiable from endomyocardial biopsy), 93598 (Cardiac output measurement by thermodilution or other indicator dilution method during congenital cardiac catheterization, discussed as not reportable with 93451), R06.09 (Other forms of dyspnea/exertional dyspnea), Z48.21 (Encounter for aftercare following heart transplant), Z87.74 (Personal history of corrected congenital malformations of heart and circulatory system), Z79.623 (Long-term current use of mammalian target of rapamycin inhibitor/sirolimus therapy), Z94.1 (Heart transplant status, discussed as redundant when Z48.21 captures heart transplant aftercare), 92997 (Percutaneous transluminal pulmonary artery balloon angioplasty, single vessel), 92998 (Percutaneous transluminal pulmonary angioplasty, additional vessel), 93597 (Right and left heart catheterization for congenital heart defect with abnormal native connections, including imaging guidance to advance catheter), 93568 (Injection during cardiac catheterization for nonselective pulmonary arterial angiography), T82.858A (Stenosis of other vascular prosthetic devices, implants and grafts, initial encounter/in-stent stenosis), Q25.47 (Right aortic arch), Q26.1 (Persistent left superior vena cava), Q90.9 (Down syndrome, unspecified), Z95.3 (Presence of xenogenic heart valve/Contegra bovine pulmonary valve), 33902 (Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral), 33904 (Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion), 37238 (Open or percutaneous placement of intravascular stent, initial vein), 37241 (Vascular embolization or occlusion, venous, radiological supervision and interpretation), 93594-XU (Right heart catheterization for congenital heart defect with abnormal native connections, including imaging guidance to advance catheter, separately reportable with modifier XU), 93569 (Injection during cardiac catheterization with imaging supervision and interpretation; selective pulmonary arterial angiography, unilateral), 93585 (Venography for congenital heart defect, azygos/hemiazygos venous system), Q25.6 (Stenosis of pulmonary artery), T82.398A (Other mechanical complication of other vascular grafts, initial encounter/Glenn anastomosis obstruction), Q24.0 (Dextrocardia), Q26.8 (Other congenital malformations of great veins/bilateral superior vena cava and hepatic venous drainage to atria context), Q27.8 (Other specified congenital malformations of peripheral vascular system), Q89.01 (Asplenia, congenital), I87.8 (Other specified disorders of veins/azygos venovenous collateral), I82.C11 (Acute embolism and thrombosis of right internal jugular vein), Z79.82 (Long-term current use of aspirin), Z79.02 (Long-term current use of antithrombotics/antiplatelets), modifier XU (Unusual non-overlapping service), modifier 59 (Distinct procedural service), CHD (Congenital heart disease), HLHS (Hypoplastic left heart syndrome), AVSD (Atrioventricular septal defect), TOF (Tetralogy of Fallot), TAPVR (Total anomalous pulmonary venous return), DORV (Double outlet right ventricle), PFO (Patent foramen ovale), PDA (Persistent/patent ductus arteriosus), RHC (Right heart catheterization), LHC (Left heart catheterization), RV (Right ventricle), RA (Right atrium), PA (Pulmonary artery), RLPA (Right lower pulmonary artery), RUPA (Right upper pulmonary artery), MPA (Main pulmonary artery), SVC (Superior vena cava), LSVC (Left superior vena cava), IVC (Inferior vena cava), RIJ (Right internal jugular vein), LIJ (Left internal jugular vein), Qp:Qs (Pulmonary-to-systemic flow ratio)
Topics Covered: congenital interventional cardiology coding, congenital cardiac intervention coding, congenital heart disease CPT coding, cardiac catheterization lab coding, congenital cardiac cath operative report coding, interventional cardiology operative report review, ASD closure coding, PFO closure coding, PDA closure coding, septal defect closure coding, pulmonary artery angioplasty coding, pulmonary vein angioplasty coding, aortic coarctation angioplasty coding, pulmonary artery stenting, pulmonary vein stenting, collateral embolization, venovenous collateral embolization, endomyocardial biopsy coding, right heart catheterization with endomyocardial biopsy, right heart cath separate medical necessity, transplant surveillance biopsy coding, routine transplant surveillance, pulmonary hypertension evaluation, exertional dyspnea evaluation, OIG scrutiny for RHC with heart biopsy, NCCI bundling edits, modifier XU usage, modifier 59 usage, fluoroscopy bundling, ultrasound guidance bundling, vascular access bundling, ECG monitoring bundling, rhythm strip bundling, contrast injection bundling, closure device bundling, radiologic supervision and interpretation, separately reportable diagnostic cardiac catheterization, separately reportable angiography, cardiac cath medical necessity, heart transplant aftercare, orthotopic heart transplantation, hypoplastic left heart syndrome history, staged single-ventricle palliation, donor-derived cell-free DNA, AlloSure, graft dysfunction evaluation, acute cellular rejection, antibody-mediated rejection, biopsy pathology pending, sirolimus therapy, mTOR inhibitor long-term use, right internal jugular venous access, Swan-Ganz catheter, hemodynamic assessment, thermodilution cardiac output, Fick cardiac output calculation, pulmonary vascular resistance, pulmonary artery pressures, pulmonary capillary wedge pressure, right atrial pressure, right ventricular pressure, cardiac index, oxygen saturation, complete RHC documentation, cardiac output add-on code rules, congenital versus noncongenital cath base codes, Down syndrome coding, repaired complete atrioventricular septal defect, repaired Tetralogy of Fallot with pulmonary atresia, repaired discontinuous pulmonary arteries, pulmonary artery unifocalization, bilateral superior vena cava, persistent left superior vena cava, right aortic arch, bilateral branch pulmonary artery stenosis, Contegra RV-to-pulmonary artery conduit, pulmonary valve replacement, xenogenic heart valve status, bovine pulmonary valve, pulmonary artery in-stent stenosis, neointimal ingrowth, neointimal hyperplasia, proximal branch pulmonary artery stenosis, bilateral pulmonary artery stent angioplasty, simultaneous balloon angioplasty, Z-Med balloon catheter, pulmonary artery gradient reduction, post-intervention hemodynamics, post-intervention angiography bundling, main pulmonary artery angiography, nonselective pulmonary arterial angiography, selective pulmonary artery angiography not supported, guidewire placement versus contrast injection site, follow the contrast injection, right pulmonary artery angioplasty, left pulmonary artery angioplasty, abnormal native connections, repaired congenital heart defects, current congenital anatomy, residual congenital conditions, pulmonary vascular resistance, Qp equals Qs, LVEDP documentation, complex cyanotic congenital heart disease, asplenia syndrome, dextrocardia, bilateral SVC, complete AVSD, TAPVR to right-sided atrium, DORV with malposed great arteries, severe congenital pulmonary stenosis, separate hepatic venous drainage to atria, right modified Blalock-Taussig shunt, bilateral bidirectional Glenn shunts, MPA-to-LPA patch augmentation, obstructed right Glenn anastomosis, cavopulmonary anastomosis obstruction, chronic Glenn obstruction, proximal right lower pulmonary artery occlusion, severe proximal right lower pulmonary artery stenosis, severe distal right upper pulmonary artery stenosis, azygos venovenous collateral, elevated Glenn pressures, reduced pulmonary blood flow, declining systemic oxygen saturations, worsening cyanosis, Doppler echocardiography, contrast echocardiography, comprehensive congenital right and left heart catheterization, diagnostic study versus intervention, recanalization of obstructed Glenn anastomosis, balloon angioplasty of Glenn anastomosis, stent implantation of Glenn anastomosis, pulmonary artery revascularization by stent placement, separate pulmonary artery lesions, count lesions not balloons or stents, proximal RLPA stent placement, distal RUPA stent placement, Genesis stent, OptaPro balloon, Ultra-Thin SDS balloon, Amplatzer vascular plug, detachable coils, venous embolization, azygos vein angiography, venography for congenital heart defect, pulmonary angiography from Glenn shunt, nonselective pulmonary angiography from anastomosis, selective right pulmonary artery circulation angiography, right upper pulmonary artery angiography, right lower pulmonary artery angiography, innominate vein, blind-ending right superior vena cava, left Glenn circulation, right internal jugular thrombosis, alternate access site documentation, acute embolism and thrombosis of right internal jugular vein, aspirin long-term therapy, clopidogrel long-term therapy, Plavix therapy, antiplatelet therapy, newly prescribed long-term medication coding, long-term drug therapy coding, pulmonary artery lesion stent coding, cavopulmonary anastomosis stent coding, peripheral venous stent coding, Glenn stenting separate from pulmonary artery stenting, distinct vascular segments, SVC-to-PA junction, PA stenosis versus anastomotic stenosis, congenital RHC with abnormal connections, LHC documentation insufficiency, venous access and right heart cath, arterial access and left heart cath, selective versus nonselective imaging, catheter position, angiography findings documentation, intervention completion angiography bundling, congenital cardiac cath coding tips, anatomy-first coding approach, current anatomy coding, repaired congenital defect identification, diagnostic catheterization separation from intervention, treated segment identification, op report dissection, pre-op diagnosis review, HPI review, procedure body review, hemodynamics review, final angiography review, impression review, medical coding webinar content
