How To Use CPT Code 93459

CPT 93459 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 left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography. 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 93459?

CPT 93459 can be used to describe the procedure for 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, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography. This code is used when the provider performs coronary angiography, an imaging study of the vessels in the heart, and inserts tubing into an artery to inject dye into the left side of the heart and any prior bypass grafts. The provider supervises the collection of images and interprets them to identify narrowing or blockages in the vessels and assess the health of the heart.

2. Official Description

The official description of CPT code 93459 is: ‘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, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography.’

3. Procedure

1. The provider makes a small incision in the groin or arm and inserts an introducer sheath into the artery.
2. A guide wire is inserted through the sheath, and a catheter is threaded over the guide wire to engage the ostia, or openings, in the coronary arteries and any bypass grafts.
3. Contrast material, or dye, is injected into the arteries, and angiograms are performed in multiple views to visualize the vessels.
4. The provider then catheterizes the left ventricle and performs a left ventriculogram to measure pressure, volume, and blood flow in the left ventricle.
5. After completing the necessary imaging studies, the provider withdraws the catheters, removes all instruments, and applies pressure and a dressing to the wound.

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 left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography are eligible for CPT 93459. This procedure is typically performed on patients with suspected or known coronary artery disease or other heart conditions that require evaluation of the coronary arteries and left ventricle. The provider must ensure that the procedure is medically necessary and appropriate for the patient’s condition.

5. When to use CPT code 93459

CPT code 93459 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 left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography. This code should be used for each instance of the procedure performed on a patient. It should not be reported in conjunction with certain other codes, as specified in the notes.

6. Documentation requirements

To support a claim for CPT 93459, the provider must document the following information:

• Patient’s medical history and indication for the procedure
• Details of the procedure performed, including catheter placement in coronary artery(s), intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, left heart catheterization, intraprocedural injection(s) for left ventriculography, and catheter placement(s) in bypass graft(s) with bypass graft angiography
• Date and duration of the procedure
• Specific vessels and grafts accessed and evaluated
• Findings from the angiograms and left ventriculogram
• Any complications or adverse events that occurred during or after the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93459, ensure that the procedure performed meets the criteria described in the official description. The provider should not report CPT 93459 in conjunction with certain other codes, as specified in the notes. It is important to follow the specific guidelines and requirements of the payer when submitting claims for this procedure. Modifier 52, Reduced services, may be appended to the code if the provider only performs the professional component of the service. Modifier 26, Professional component, may be appended to indicate that the provider is reporting only the professional component of the service.

8. Historical information

CPT 93459 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 93459

Five similar codes to CPT 93459 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 left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed.