How To Use CPT Code 93453

CPT 93453 describes the combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision and interpretation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93453?

CPT 93453 is used to describe the combined right and left heart catheterization procedure. This procedure involves the evaluation of the heart’s function by inserting catheters into both the right and left sides of the heart. The provider performs intraprocedural injections for left ventriculography and supervises and interprets the imaging results. It is important to note that CPT 93453 should not be reported in conjunction with certain other codes, as specified in the notes.

2. Official Description

The official description of CPT code 93453 is: ‘Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. A small incision is made in the internal jugular, subclavian, or femoral vein.
3. A catheter is inserted through a flexible guide wire under fluoroscopic guidance.
4. X-ray images are used to guide the placement of the catheter throughout the procedure.
5. The provider monitors the cardiac rhythm using an electrocardiogram (ECG).
6. For right heart catheterization, the catheter is passed through the right atrium, tricuspid valve, right ventricle, pulmonary valve, and into the pulmonary artery.
7. For left heart catheterization, the catheter is passed through the aortic valve and into the left ventricle.
8. The provider may inject contrast dye into the catheter to evaluate the heart’s function using fluoroscopy.
9. At the end of the procedure, the catheter is either secured in place for ongoing monitoring or removed, and hemostasis is achieved.

4. Qualifying circumstances

CPT 93453 is performed to evaluate the function of the heart. It is typically done for diagnostic purposes and may be necessary for patients with certain cardiac conditions. The procedure requires the expertise of a provider who is skilled in performing cardiac catheterizations. It is important to note that CPT 93453 should not be reported in conjunction with certain other codes, as specified in the notes.

5. When to use CPT code 93453

CPT code 93453 should be used when a provider performs a combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision, and interpretation. It is important to follow the guidelines and notes provided to ensure accurate reporting. CPT 93453 should not be reported in conjunction with certain other codes, as specified in the notes.

6. Documentation requirements

To support a claim for CPT 93453, the provider must document the following information:

• Patient’s medical history and indication for the procedure
• Details of the procedure performed, including the approach used (internal jugular, subclavian, or femoral vein)
• Documentation of the catheter placement and movement through the heart
• Imaging supervision and interpretation
• Injection(s) for left ventriculography
• Use of contrast dye, if applicable
• Any complications or adverse events encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93453, it is important to ensure that the procedure meets the criteria outlined in the official description. The provider should be skilled in performing cardiac catheterizations and should document the necessary details to support the claim. It is also important to follow the guidelines and notes provided to ensure accurate reporting. CPT 93453 should not be reported in conjunction with certain other codes, as specified in the notes.

8. Historical information

CPT 93453 was added to the Current Procedural Terminology system on January 1, 2011. There have been no updates to the code since its addition.

9. Examples

1. A cardiologist performs a combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision, and interpretation, for a patient with suspected heart disease.
2. A cardiac surgeon performs a combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision, and interpretation, for a patient prior to valve repair surgery.
3. An interventional cardiologist performs a combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision, and interpretation, for a patient with coronary artery disease.
4. A cardiac electrophysiologist performs a combined right and left heart catheterization procedure, including intraprocedural injections for left ventriculography, imaging supervision, and interpretation, for a patient with arrhythmias.