A diagnostic cardiac catheterization is performed demonstrating two-vessel coronary disease. Due to contrast load, the procedure is staged. A lesion in the left anterior descending artery (LAD) is treated by a drug-eluting stent at the initial session and the right coronary lesion is treated at a separate encounter. Can the injection of the coronary arteries during the second encounter be coded and billed with code 93454 (coronary angiography only)?
Medical necessity is required to code and bill another diagnostic study. For example, a prior study is available but is documented in the medical record as follows: The patient’s condition with respect to the clinical indication has changed since the prior study. A staged intervention where coronary injections are done prior to the procedure, to set up the procedure, is not billable.