On Demand - Coding for Congenital Heart Catheterization and Therapeutic Procedures-Question and Answer

Question and Answer

Pdf Summary

In this document, there is a Q&A session on coding for congenital heart catheterizations and therapeutic services. Some of the questions asked include whether both right and left heart catheterizations require hemodynamics, examples of separate medical necessity for RHC with an endo biopsy, why PFO and Bicuspid are not coded as congenital, and why 93462 was not added in a specific case. It is explained that hemodynamics are required for both right and left heart catheterizations. The reason for not coding PFO and Bicuspid as congenital is not definitively answered, but it is stated that they should be coded with non-congenital cath codes according to the CPT Congenital Cath Guidelines. In the case example mentioned, 93462 would not apply in crossing the ASD/PFO because it is transseptal puncture through an intact septum. In another case example, both right and left heart catheterizations were billed because the patient experienced symptoms of shortness of breath. The document also addresses questions on billing for congenital conditions, billing right heart cath with other procedures, and whether a diagnostic catheterization can be billed along with a procedure for placing a Melody valve. The document concludes by stating that according to the CPT instructions, a diagnostic catheterization can be billable under certain circumstances, and there are no bundling issues for reporting a congenital heart cath with a pulmonary artery stent placement.

Keywords

coding

congenital heart catheterizations

therapeutic services

hemodynamics

medical necessity

RHC

endo biopsy

PFO

Bicuspid

93462