How To Use CPT Code 93457

CPT 93457 describes the procedure for catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93457?

CPT 93457 can be used to describe the procedure of catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation. This code also includes catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization.

2. Official Description

The official description of CPT code 93457 is: ‘Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization.’

3. Procedure

1. The provider introduces a catheter through the skin and advances it into the peripheral artery under fluoroscopic guidance.
2. The provider moves the guide wire into the peripheral artery and advances the tip of the catheter to the opening of the coronary artery and the bypass graft.
3. The provider secures the catheter tip at the beginning of the coronary artery and utilizes the catheter for placement in the vein and internal mammary grafts.
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 introduces an additional pulmonary catheter into the pulmonary artery under fluoroscopic guidance to measure the pressure and blood flow in the right side of the heart.
6. The provider removes the catheter and applies pressure on the wound to stop the bleeding.

4. Qualifying circumstances

Patients who require catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization are eligible for CPT 93457. This procedure is typically performed to assess any coronary artery disease or stenosis within the artery. It is important to note that CPT 93457 should not be reported in conjunction with certain other codes, as specified in the notes.

5. When to use CPT code 93457

CPT code 93457 should be used when the provider performs catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization. It is important to follow the guidelines and notes provided to ensure accurate reporting.

6. Documentation requirements

To support a claim for CPT 93457, the provider must document the following information:

• Details of the catheter placement in coronary artery(s) and bypass graft(s)
• Intraprocedural injection(s) performed for coronary angiography and bypass graft angiography
• Imaging supervision and interpretation
• Date and duration of the procedure
• Contrast material used
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 93457, it is important to follow the specific guidelines provided. Ensure that the procedure meets the criteria for catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization. Be aware of any codes that should not be reported in conjunction with CPT 93457. Use the appropriate modifiers, such as modifier 26 for the professional component or modifier TC for the technical component, if applicable.

8. Historical information

CPT 93457 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 93457

Five similar codes to CPT 93457 include:

• CPT 93458: This code is used for catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization, with complex coronary angiography including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, when performed.
• CPT 93459: This code is used for catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization, with complex coronary angiography including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, when performed; with left ventriculography.