Cardiology Question for the Week of June 3, 2024

Question:

What’s not included in codes 93590 and 93591?

Answer:

If documentation criteria are met (see below), true, diagnostic right heart catheterization services (CPT® codes 93451, 93456, 93457, 93530) as well as true, diagnostic coronary arteriography codes (CPT 93454, 93455, 93456, 93457, 93563, 93564) may be billed. These procedures must be separate and distinct from the PVL service. The documentation criteria include the following:

• No previous study is available.
• Full and complete diagnostic imaging is performed.
• The physician documents that the patient’s signs and symptoms had changed since the priorstudy, which necessitated a new study. The physician documents that the patient’s signs and symptoms changed during the PVL procedure.
• The physician documents that the previous study is not satisfactory
• Note: Other cardiac procedures are coded separately if not included in PVL procedure. Assign modifier 59 for services (the cardiac cath or coronary imaging procedure) performed on the same date of service/same session as the PBL procedure if the above criteria are met.

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