Beyond the Cath: Peripheral Interventions in the Cath Lab

Codes Discussed: 93593-93597 (Congenital cardiac catheterization codes referenced for bundled nonselective catheterization and congenital angiography parent codes), 93563 (Selective coronary artery angiography during congenital cardiac catheterization), 93564 (Aortocoronary bypass graft angiography and in situ arterial conduit angiography), 93568 (Nonselective pulmonary arterial angiography), 93569 (Selective pulmonary arterial angiography, unilateral), 93573 (Selective pulmonary arterial angiography, bilateral), 93575 (Major aortopulmonary collateral artery angiography/MAPCA angiography), 93574 (Pulmonary vein angiography), 75825 (Inferior vena cavography), 75827 (Superior vena cavography), 93584 (Venography for bilateral SVC/anomalous or persistent left or right SVC), 93585 (Venography for azygos/hemiazygos venous system), 93586 (Coronary sinus venography), 93587 (Venography for venovenous collaterals at or above the heart), 93588 (Venography for venovenous collaterals below the heart), 75605 (Thoracic aortography), 75625 (Abdominal aortography), 75630 (Abdominal aortography with aorto-iliofemoral runoff), 75710 (Unilateral extremity arteriography), 75716 (Bilateral extremity arteriography), G0278 (Nonselective iliofemoral angiography), 36251-36254 (Selective renal angiography codes), 75822 (Bilateral extremity venography), 75820 (Unilateral extremity venography), 75774 (Each additional vessel imaged with selective angiography), 36200 (Nonselective arterial catheter placement in aorta), 36215 (First-order selective arterial catheterization above diaphragm), 36216 (Second-order selective arterial catheterization above diaphragm), 36217 (Third-order selective arterial catheterization above diaphragm), 36218 (Each additional second-order or higher vessel catheterized within same above-diaphragm vascular family), 36245 (First-order selective arterial catheterization below diaphragm), 36246 (Second-order selective arterial catheterization below diaphragm), 36247 (Third-order selective arterial catheterization below diaphragm), 36248 (Each additional second-order or higher vessel catheterized within same below-diaphragm vascular family), 36010 (Nonselective venous catheter placement in vena cava), 36011 (First-order selective venous catheterization), 36012 (Second-order or higher selective venous catheterization), 37246 (Percutaneous transluminal angioplasty, initial artery), 37247 (Percutaneous transluminal angioplasty, each additional artery), 33897 (Percutaneous transluminal angioplasty for native or recurrent aortic coarctation), 92997 (Percutaneous transluminal pulmonary artery balloon angioplasty, single vessel), 92998 (Percutaneous transluminal pulmonary angioplasty, each additional vessel), 37248 (Percutaneous transluminal angioplasty, initial vein), 37249 (Percutaneous transluminal angioplasty, each additional vein), 37236 (Intravascular stent placement, initial artery), 37237 (Intravascular stent placement, each additional artery), 33894 (Aortic coarctation stent placement crossing major side branches), 33895 (Aortic coarctation stent placement not crossing major side branches), 33900 (Pulmonary artery stent placement, normal native connections, unilateral), 33901 (Pulmonary artery stent placement, normal native connections, bilateral), 33902 (Pulmonary artery stent placement, abnormal connections, unilateral), 33903 (Pulmonary artery stent placement, abnormal connections, bilateral), 33904 (Pulmonary artery stent placement, each additional vessel), 37238 (Intravascular stent placement, initial vein), 37239 (Intravascular stent placement, each additional vein), 37241 (Venous embolization or occlusion, including venovenous collateral embolization), 37242 (Arterial or arteriovenous embolization or occlusion, including aortopulmonary collateral embolization), 37243 (Embolization for benign or malignant tumor, organ ischemia, or infarction), 37244 (Embolization for arterial or venous hemorrhage or lymphatic extravasation), 93582 (Percutaneous transcatheter PDA occlusion), 93662 (Intracardiac echocardiography, separately reportable with PDA occlusion), 76937 (Ultrasound guidance for vascular access, separately reportable for some peripheral embolization scenarios but included in congenital cardiac catheterization when performed by the same operator), 37252 (Intravascular ultrasound, initial noncoronary vessel), 37253 (Intravascular ultrasound, each additional noncoronary vessel), 37200 (Transcatheter biopsy), 75970 (Radiological supervision and interpretation for transcatheter biopsy), 93597 (Congenital right and left heart catheterization with abnormal native connections, used in Fontan/transjugular liver biopsy example), 93573 (Bilateral pulmonary angiography, used in Fontan/transjugular liver biopsy example), 36011 (Selective hepatic vein catheterization, used in transjugular liver biopsy example), modifier XS (Separate structure modifier, used in example for embolization of separate right and left lung surgical fields), CHD (Congenital heart disease), TOF (Tetralogy of Fallot), HLHS (Hypoplastic left heart syndrome), DORV (Double outlet right ventricle), PDA (Patent ductus arteriosus), MAPCA/MAPCAs (Major aortopulmonary collateral artery/arteries), APCA (Aortopulmonary collateral artery), VSD (Ventricular septal defect), RVOT (Right ventricular outflow tract), RV-PA conduit (Right ventricle-to-pulmonary artery conduit), Fontan, Glenn, SVC (Superior vena cava), IVC (Inferior vena cava), PA (Pulmonary artery), PV (Pulmonary vein), RIMA (Right internal mammary artery), LIMA (Left internal mammary artery), EVOH (Ethylene vinyl alcohol embolic agent), PDA occluder device, Amplatzer duct occluder, coil embolization, vascular plug embolization, liquid embolic embolization, absolute ethanol sclerosing agent

Topics Covered: peripheral interventions in the congenital cardiac catheterization lab, congenital heart disease peripheral intervention coding, cardiovascular anatomy and circulation, pulmonary circulation, systemic circulation, normal cardiac anatomy, heart chambers, atria, ventricles, cardiac valves, atrioventricular valves, semilunar valves, pulmonary artery, pulmonary veins, aorta, superior vena cava, inferior vena cava, right atrium, right ventricle, left atrium, left ventricle, mitral valve, aortic valve, tricuspid valve, pulmonary valve, great vessels, oxygenated blood flow, deoxygenated blood flow, collateral vessels, aortopulmonary collaterals, major aortopulmonary collateral arteries, venovenous collaterals, systemic-to-pulmonary collaterals, systemic-to-systemic collaterals, cyanotic heart disease, single-ventricle physiology, Glenn circulation, Fontan circulation, collateral vessels causing cyanosis, reduced oxygen saturation, volume overload, conduits and baffles, Mustard/Senning baffle, RV-to-PA conduit, repaired structures versus native vessels, peripheral interventions for congenital heart disease, catheter-based procedures outside cardiac chambers, pediatric interventional cardiology, adult congenital heart disease interventional cardiology, repeat congenital catheter procedures, palliating congenital birth defects, long-term management of childhood surgical repairs, pulmonary artery angioplasty, Fontan stenting, collateral embolization, PDA closure, liver biopsy, interventions performed inside versus outside cardiac chambers, pulmonary valvuloplasty exclusion from peripheral procedures, TPVR exclusion from peripheral procedures, ASD closure exclusion from peripheral procedures, VSD closure exclusion from peripheral procedures, endomyocardial biopsy exclusion from peripheral procedures, Tetralogy of Fallot peripheral interventions, pulmonary artery stenosis, branch pulmonary artery stenosis, right ventricular outflow tract obstruction, conduit stenosis, venous interventions, diagnostic angiography, lifelong TOF catheter-based procedures, hypoplastic left heart syndrome peripheral interventions, Glenn pathway stenosis, Fontan pathway stenosis, pulmonary artery stenosis, branch pulmonary artery stenosis, venovenous collateral vessels, aortopulmonary collateral vessels, Fontan-associated liver disease, venography, transjugular liver biopsy, single-ventricle palliation, Norwood procedure, Glenn procedure, Fontan procedure, neoaorta, Sano shunt, conduit anatomy, altered catheter pathways after Norwood, bidirectional Glenn procedure, SVC-to-PA connection, passive pulmonary blood flow, Fontan pathway, IVC-to-pulmonary artery connection, Fontan-associated venous pathways, Fontan pathway angioplasty, Fontan pathway stenting, collateral embolization in Fontan patients, pulmonary stenosis interventions, pulmonary artery stent re-dilation, pulmonary vein stenosis, post-repair TAPVR stenosis, isolated pulmonary vein stenosis, pulmonary vein angioplasty, pulmonary vein stenting, pulmonary vein restenosis, coarctation of aorta angioplasty, coarctation stenting, adult coarctation after initial repair, double outlet right ventricle peripheral interventions, DORV with conduit interventions, repaired congenital anatomy, patent ductus arteriosus closure, PDA device closure, PDA coil embolization, Amplatzer duct occluder, PDA anatomy and device selection, basic vessel ordering for coders, vascular families, innominate family, brachiocephalic family, left common carotid family, left subclavian family, aortic arch arterial ordering, first-order vessel catheterization, second-order vessel catheterization, third-order vessel catheterization, beyond third-order catheterization, contralateral catheterization, ipsilateral catheterization, subclavian branch anatomy, vertebral artery, internal thoracic artery, internal mammary artery, thyrocervical trunk, costocervical trunk, dorsal scapular artery, venous ordering for catheterization coding, vena cava catheterization, hepatic vein catheterization, first-order venous branch, second-order venous branch, peripheral angiography and catheterization for CHD, arterial peripheral angiography, venous peripheral angiography, nonselective catheterization bundled into congenital cardiac catheterization, selective catheterization bundled into congenital angiography add-on codes, separate catheterization only outside congenital cardiac and pulmonary angiography services, selective hepatic vein catheterization during transjugular liver biopsy, pulmonary artery angiography, pulmonary vein angiography, SVC venography, IVC venography, azygos venous system, hemiazygos venous system, coronary sinus venography, venovenous collateral venography, radiology angiography codes, selective angiography coding, arterial angiography, venography coding, peripheral angioplasty for congenital heart disease, percutaneous transluminal angioplasty, balloon dilation of narrowed vessels, pulmonary artery stenosis angioplasty, aortic coarctation angioplasty, stenotic conduit angioplasty, vein stricture angioplasty, Fontan pathway vein intervention, Mustard procedure vein pathway intervention, one code per vessel for angioplasty, multiple lesions in same vessel, single lesion spanning two vessels, conduit angioplasty based on anatomic location, peripheral stent placement for congenital heart disease, stent placement to maintain vessel patency, pulmonary artery stenting, coarctation stenting, conduit stenting, vein stenting, one code per vessel regardless of number of stents, angioplasty bundled into stent placement, catheterization separately reported for aorta/artery and vein stenting, catheterization not separately reported for aortic coarctation and pulmonary artery stenting, major side branches of thoracic aorta, major side branches of abdominal aorta, peripheral embolization for congenital heart disease, embolization to redirect blood flow, embolization to reduce overload, embolization to improve oxygen saturation, embolization to eliminate inefficient blood flow, embolization to prepare for staged surgical repair, embolization devices, coils, vascular plugs, liquid embolics, EVOH liquid embolic systems, Onyx embolic system, Squid embolic system, PHIL embolic system, cyanoacrylate tissue adhesive embolization, n-BCA liquid embolic system, sclerosing agents, absolute ethanol, venous embolization coding, arterial embolization coding, arteriovenous embolization coding, PDA occlusion coding, embolization for tumor, embolization for organ ischemia, embolization for infarction, embolization for active bleeding, embolization for hemorrhage, embolization for lymphatic extravasation, chylous effusion embolization, surgical field definition for embolization, same surgical field embolization, separate surgical field embolization, right lung versus left lung as separate organs, counting surgical fields instead of vessels or devices, completion angiograms bundled into embolization, roadmapping bundled into embolization, image guidance bundled into embolization, separately reportable catheter placements with embolization, ultrasound guidance for vascular access documentation, intravascular ultrasound in pediatric interventions, peripheral occlusion for congenital heart disease, PDA occluder device, nonsurgical PDA closure, aortic arch aortography bundled into PDA occlusion, right and left heart cath bundled into PDA occlusion, intracardiac echocardiography separately reportable with PDA occlusion, cardiac angiography separately reportable with PDA occlusion, transjugular liver biopsy in Fontan patients, Fontan-associated liver disease biopsy, elevated venous pressures, transplant surveillance, congenital right and left heart catheterization with liver biopsy, bilateral pulmonary angiography during Fontan surveillance, hepatic vein catheterization, transcatheter biopsy, biopsy radiological supervision and interpretation, final congenital peripheral intervention coding takeaways, current congenital anatomy review, prior surgical repair review, Fontan repair coding, Glenn repair coding, TOF repair coding, conduit intervention coding, identifying peripheral structure treated, aorta intervention coding, pulmonary artery intervention coding, vein intervention coding, conduit intervention coding, collateral vessel intervention coding, treatment goal documentation, opening a vessel, keeping a vessel open, intentionally closing a vessel, obtaining a biopsy, angioplasty versus stent versus embolization versus occluder device versus biopsy, multiple vessels treated, multiple lesions treated, bundled catheterization and angiography, separately reportable imaging and supervision, peripheral intervention versus congenital cardiac catheterization code families, congenital cardiology coding education, medical coding webinar content