Can we code 93590 and 93591 separately for the same encounter? Are there specific codes that cannot be assigned when reporting these?
Both codes 93590 and 93591, which define placement of initial occlusion devices fluoroscopy (76000) as well as angiography and radiological supervision and interpretation (i.e., S & I or RSI), are included in PVL procedures and should not be separately coded at the same encounter. When performing the placement of the initial (mitral valve) closure device (i.e., code 93590), do not assign separate codes for left heart catheterization, left ventriculography, or a transseptal puncture (i.e., 93542, 93543, 93458, 93459, 93460, 93461, 93565, 93593–93598). If, however, a transapical left heart access is performed (CPT code +93462), it may be separately reported in addition to the PVL procedure. When performing the placement of the initial (aortic valve) closure device (i.e., code 93591), do not assign separate codes for left heart catheterization, left ventriculography, or a transseptal puncture (i.e., 93542, 93543, 93458, 93459, 93460, 93461, 93593–93598, 93565). Additionally, code 93567 (for an aortic root angiogram) may not be assigned when submitting code 93591, but may be assigned with code 93590. If, however, a transapical left heart is performed (CPT code +93462), it may be separately reported in addition to the PVL procedure.
This question was answered in our annual Cardiology Reimbursement & Compliance Update webcast. For more hot topics relating to cardiology services, please visit our store or call us at 1.800.252.1578, ext. 2.
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