Cardiology Question for the Week of April 25, 2022

Question:

How would you code the following scenario? An interventional cardiologist performs a percutaneous left heart catheterization, then selective injections of the left ventricle and coronary arteries for diagnostic purposes followed by mechanical thrombectomy of the LAD artery with subsequent drug-eluting stent placement in the LAD.

Answer:

For a physician setting you would code 93458-59, 92973, 92928-LD and for a hospital setting 93458-59, 92973, C9600-LD. It is appropriate to report the documented diagnostic left heart catheterization and associated injections with code 93458 because it is from this data that the decision to intervene was made. Mechanical thrombectomy is reported with add-on code +92973, and the stent deployed within the LAD is reported with code 92928 (for physician billing) or C9600 (for outpatient Medicare hospital billing).