93458, cpt 93458, cpt code 93458, 93458 cpt code

CPT Code 93458 | Description, Procedure & Billing Guidelines

The 93458 CPT code describes a procedure in which a catheter is placed in the patient’s coronary artery/arteries for coronary angiography with intraprocedural injections for left ventriculography.

1. What Is CPT 93458?

CPT 93458 covers a procedure in which a provider performs imaging interpretation and supervision for coronary angiography. This procedure includes intraprocedural injections for left ventriculography.

Intraprocedural injections are needed to assess the artery for stenosis or coronary artery disease.

Only imaging supervision and interpretation are covered with CPT code 93458.

2. Description

The CPT book describes the 93458 CPT code as: “Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision, and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography when performed.”

3. Procedure

The 93458 CPT code procedure starts with prepping and anesthetizing the patient. Then, a provider uses a catheter and moves it through the patient’s skin into the peripheral artery. This is done under fluoroscopic guidance.

After that, the provider moves the catheter tip towards the opening of the coronary artery and secures it at the beginning of the artery.

Once the catheter is appropriately positioned, they inject contrast material through it. This goes into the patient’s coronary artery to check the catheter’s position and to make angiographic images.

Once the first images are made, the health provider puts another catheter into the left side of the patient’s heart. This is done to measure blood pressure and flow and is performed under fluoroscopic guidance.

The provider starts with left ventriculography by injection contrast through the catheter into the left ventricle under fluoroscopic guidance to measure the cardiac function.

Once the cardiac function is checked, the provider removes the catheter and stops the bleeding by applying pressure to the wound.

The provider removes the catheter and applies pressure for several minutes on the wound to stop the bleeding.

4. Billing Guidelines

Only the provider who performed the imaging interpretation and supervision during the 93458 procedure can bill this code.

CPT 93458 can not be billed in combination with;

  • CPT 0643T;
  • CPT 0545T;
  • CPT 0544T;
  • CPT 0484T;
  • CPT 0483T;
  • CPT 0345T;
  • CPT 0408T;
  • CPT 0415T;
  • CPT 0414T;
  • CPT 0411T;
  • CPT 0410T;
  • 0409T; or
  • CPT 33418

5. Does CPT 93458 Need A Modifier?

Report modifier 26 with CPT 93458 if you bill the professional component alone.

You can use modifier TC with this code for reporting the technical component alone. It is also possible that the hospital provided the technical component. However, you can not add the TC modifier to the claim in that care.

You can not add any modifier to this code if you report CPT code 93458 as a global service.

6. Resources

https://www.aapc.com/blog/28538-resuscitate-your-cardiac-catheterization-coding/

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56500&ver=16

CPT Professional 2022

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