Compliance Question of the Week – Cardiology

When would it be correct to assign the code 93463?

When would it be correct to assign the code 93463?

If a patient has a diagnostic heart cath with IVUS one day and then is taken back to have intracoronary stents deployed with IVUS the next day, can IVUS be coded at both sessions?

If a patient comes into our hospital (probably in A-Fib), and an EKG confirms the A-Fib, then they are taken to the EP suite where a cardioversion is performed, are we allowed to code for the EKG with a 59 modifier?

A diagnostic heart cath with coronary angiogram was done with a stent placement. Three hours later the patient complains of pain and returns to the cath lab for another coronary angiogram. Can we code both?

A question came from the director of our cardiovascular services (CVS) department today. When a right heart catheterization is done to aid in the placement of a CS lead, is that reported separately? Our dictation only briefly gives findings of RA and LA pressures. We also do an angiogram with the right heart cath. If it is something we can bill for, can you please advise what would need to be included in the dictation? We are not required to add a modifier on the RHC code.

Can we code 93655 in addition to 93653 when the initial arrhythmia was atrial tachycardia (AT) in right atrium but then an atrial flutter (atypical) was discovered in the left atrium? Technically, this is a different arrhythmia; however, if both were solo, would they both map to the same 93653?

If we remove a left ventricular lead from an ICD and replace it with a new one, would we report just 33224?

I’ve got a coronary intervention case with one stent placed into the diagonal via a vein graft and a second stent placed into the LAD via a LIMA graft. Would this be reported as C9604-LD x2 or C9604-LD and C9605-LD instead?

Can you provide information about when it is appropriate to use modifier 63?

If patient has a diagnostic heart cath with IVUS one day and then is taken back to have intracoronary stents deployed with IVUS the next day, can IVUS be coded at both sessions?

Can a code for ECG tracings be reported if the EKG is performed with a percutaneous coronary artery interventional procedure?