Cardiology Question for the Week of May 15, 2017

Cardiology Compliance Question of the Week

Question:

If a patient is brought to the cardiac cath lab and only bypass grafts were visualized (for example, SVG [saphenous vein graft] to the right coronary artery [RCA], and SVG to the circumflex) with no native coronary arteries being injected or imaged, what is the appropriate CPT procedure code to charge?

Answer:

According to the American College of Cardiology (ACC), when native coronaries and grafts are studied, the following may be the appropriate codes:

  • 93455 (if only native coronaries and grafts)
  • 93457 (native coronaries, grafts, and right heart cath)
  • 93459 (native coronaries, grafts and left heart cath)
  • 93461 (native coronaries, grafts, right heart cath, and left heart cath).

There is no code for only graft angiography.

Because the procedure performed is less than what the code descriptor requires, report the appropriate code from the choice above that includes native coronary angiography and add modifier -52 (reduced services).

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.