Compliance Question of the Week – Cardiology

During a recent transcatheter mitral valve repair (TMVR), we used three prostheses. Can we assign code 33418 plus 33419 x 2?

I have a patient who received an implantable cardioverter-defibrillator (ICD) dual-chamber device from company A. During the defibrillation threshold testing (DFT) phase, the device would not convert the patient from ventricular fibrillation, and rescue shocks were performed. The patient returned the following day and a new ICD generator from company B was inserted. This device has a higher joule output that will allow the patient to be converted from the arrhythmia.

Can I assign the following CPT® code for an ICD generator change?

33263 Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; dual lead system

If a temporary pacemaker lead is inserted during a diagnostic heart cath, is it appropriate to charge for this lead placement if the patient does not leave the procedure room with it (the pacemaker lead)?

Is the coding of a diagnostic cardiac catheterization different based on the access into the body, for example: radial versus femoral artery?

Can a right heart catheterization (RHC) be billed on the same claim as a heart biopsy?

What code should be reported when only venous grafting is performed?

Is 93567 the appropriate code for the angiographic evaluation of an ascending aortic dissection without a cardiac catheterization?

A patient was brought to the cardiac cath lab, and only coronary bypass grafts were visualized. No native coronary arteries were injected or imaged, and no heart cath was performed. What is the appropriate CPT® procedure code to assign?

What code would I use for the second stent if the doctor’s dictation states “MI with culprit lesions in the LAD and RC”? If I can only assign code 92941 one time, what code do I use for the additional artery?

What is the best code to assign for a generator change from a dual-chamber to a single-chamber? Our cardiologist capped off a lead and then replaced a dual-chamber with a single-chamber pacemaker.

How is the following scenario coded? A patient has a SVG anastomosed to the LC obtuse marginal (OM). Next, this graft “jumps” to the RC posterolateral branch. Through the vein graft, the OM lesion is treated with angioplasty and bare metal stenting and a second lesion in the posterolateral branch of the RC is treated with angioplasty and bare metal stenting.

Last week’s answer to pediatric echocardiograms made me wonder what codes would be assigned for the congenital echocardiogram.