How do the new 2022 congenital catheterization code directives define normal native connections?
The directives define normal or abnormal connections to define the connection variations of anatomic connections from the great veins to the atria, atria to the ventricles, and ventricles to the great arteries to assist with appropriate right heart catheterizations: Cardiac Catheterization. Normal native connections exist when the blood flow follows the expected course through the right and left heart chambers and great vessels (i.e., superior vena an/inferior vena cava to right atrium, then right ventricle, then pulmonary arteries for the right heart; left atrium to left ventricle, then aorta for the left heart). Examples of normal congenital defects are acyanotic defects such as isolated atrial septal defect, ventricular septal defect, or patent ductus arteriosus. Codes 93593 or 93596 would apply.