How To Use CPT Code 93454

CPT 93454 is a code used for catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision, and interpretation. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 93454.

1. What is CPT 93454?

CPT 93454 is a code used to represent the procedure of catheter placement in coronary artery(s) for coronary angiography, which includes intraprocedural injection(s) for coronary angiography, imaging supervision, and interpretation. This code is used by medical coders and billers to report the imaging supervision and interpretation for this procedure.

2. 93454 CPT code description

The official description of CPT code 93454 is: “Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider introduces a catheter through the skin and moves the guide wire into the peripheral artery under fluoroscopic guidance.
3. The tip of the catheter is advanced to the coronary artery opening and secured at the beginning of the coronary artery.
4. The provider injects contrast material through the catheter into the artery to check the position of the catheter and produces angiographic images.
5. The provider removes the catheter and applies pressure on the wound to stop the bleeding.
6. The provider who performs imaging supervision and interpretation for this procedure reports CPT 93454.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 93454 services are those who require coronary angiography to assess any coronary artery disease or any stenosis within the artery. This procedure is typically performed on patients with symptoms of coronary artery disease, such as chest pain or shortness of breath, or those with a high risk of developing coronary artery disease due to factors such as age, family history, or pre-existing medical conditions.

5. When to use CPT code 93454

It is appropriate to bill the 93454 CPT code when the provider performs imaging supervision and interpretation for a coronary angiography in which injections are performed to assess any coronary artery disease or any stenosis within the artery. This code should be reported only for the imaging supervision and interpretation for this procedure.

6. Documentation requirements

To support a claim for CPT 93454, the following information needs to be documented:

• Patient’s medical history and symptoms indicating the need for coronary angiography.
• Details of the procedure, including the type of catheter used, the method of catheter insertion, and the specific coronary artery(s) examined.
• Findings from the angiographic images, including any abnormalities or blockages in the coronary artery(s).
• Any complications or adverse events that occurred during the procedure.
• Interpretation of the angiographic images by the provider.

7. Billing guidelines

When billing for CPT code 93454, it is important to follow these guidelines:

• Append professional component modifier 26 to the code if reporting only the professional component for the service.
• Append technical component modifier TC to the code if reporting only the technical component for the service, unless the hospital provided the technical component. In that case, do not append modifier TC because the hospital’s portion is inherently technical.
• Do not append a professional or technical modifier to the code when reporting a global service in which one provider renders both the professional and technical components.
• Do not report CPT 93454 in conjunction with 33418, 0345T, 0483T, 0484T, 0544T, 0545T, 0643T, for coronary angiography intrinsic to the valve repair, annulus reconstruction procedure, or left ventricular restoration device implantation.

8. Historical information

CPT 93454 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Similar codes to CPT 93454

Five similar codes to CPT 93454 and how they differentiate from CPT 93454 are:

1. CPT 93455: Includes catheter placement in bypass graft(s) for coronary angiography.
2. CPT 93456: Includes catheter placement in both coronary artery(s) and bypass graft(s) for coronary angiography.
3. CPT 93457: Includes catheter placement in coronary artery(s) for coronary angiography and left heart catheterization.
4. CPT 93458: Includes catheter placement in coronary artery(s) for coronary angiography, left heart catheterization, and bypass graft angiography.
5. CPT 93459: Includes catheter placement in both coronary artery(s) and bypass graft(s) for coronary angiography, and left heart catheterization.

10. Examples

Here are 10 detailed examples of CPT code 93454 procedures:

1. A 55-year-old male with a history of chest pain undergoes coronary angiography to assess for coronary artery disease.
2. A 65-year-old female with a family history of coronary artery disease undergoes coronary angiography as part of a diagnostic workup for shortness of breath.
3. A 70-year-old male with a history of hypertension and diabetes undergoes coronary angiography to evaluate the extent of coronary artery disease.
4. A 60-year-old female with a history of smoking and high cholesterol undergoes coronary angiography to assess for any blockages in the coronary arteries.
5. A 50-year-old male with a history of chest pain and a positive stress test undergoes coronary angiography to evaluate the need for further intervention.
6. A 45-year-old female with a history of chest pain and an abnormal EKG undergoes coronary angiography to assess for coronary artery disease.
7. A 75-year-old male with a history of angina and previous myocardial infarction undergoes coronary angiography to evaluate the patency of his coronary arteries.
8. A 67-year-old female with a history of shortness of breath and a positive stress test undergoes coronary angiography to assess for any blockages in the coronary arteries.
9. A 58-year-old male with a history of chest pain and an abnormal EKG undergoes coronary angiography to evaluate the need for further intervention.
10. A 62-year-old female with a history of hypertension and diabetes undergoes coronary angiography to assess for coronary artery disease and the need for further treatment.