How To Use CPT Code 93461

CPT 93461 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 right and 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 93461?

CPT 93461 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 right and 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 a comprehensive evaluation of heart function by inserting a catheter through a blood vessel and using fluoroscopic guidance and contrast injections to visualize the heart and its structures.

2. Official Description

The official description of CPT code 93461 is: ‘Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and 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 prepares the patient for the procedure and administers anesthesia as necessary.
  2. A catheter is inserted through a sheath into a blood vessel, typically the femoral vein.
  3. Under fluoroscopic guidance, the provider advances the catheter through the right heart chambers into the pulmonary artery, taking pressure measurements and additional measurements such as diastolic pressure, oxygen saturation, and Fick cardiac output.
  4. The provider then accesses the arterial system and reaches the ascending aorta using a needle, guidewire, sheath, and catheter.
  5. The provider measures aortic root pressure and moves the catheter to a coronary artery ostium to evaluate pressure, waveform, and obtain images.
  6. The provider repeats the imaging procedure for other coronary ostia using additional catheters.
  7. The provider moves another catheter across the aortic valve into the left ventricle, measures pressures, and performs power injection to evaluate systolic function and the mitral valve.
  8. The provider performs coronary injections to assess stenosis and coronary artery disease.
  9. The provider engages the vein and internal mammary artery grafts using additional catheters and visualizes the contrast medium through X-ray technique to generate angiogram images.
  10. The provider reviews all images and may perform additional procedures as necessary, such as imaging the access site or stopping bleeding.

4. Qualifying circumstances

Patients eligible for CPT 93461 are those who require evaluation of heart function through catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and 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 procedure is typically performed on patients with suspected or known coronary artery disease or other heart conditions that require comprehensive evaluation.

5. When to use CPT code 93461

CPT code 93461 should be used when the provider performs the specific procedure described in the official description. It is important to ensure that all components of the procedure, including catheter placement in coronary artery(s), coronary angiography, imaging supervision and interpretation, right and left heart catheterization, left ventriculography, and bypass graft angiography, are performed. This code should not be used for other cardiac catheterization procedures or valve repair, annulus reconstruction procedures, or left ventricular restoration device implantation.

6. Documentation requirements

To support a claim for CPT 93461, the provider must document the following information:

  • Indication for the procedure and the need for comprehensive evaluation of heart function
  • Details of the catheter placement, including the specific coronary artery(s) and bypass graft(s) involved
  • Date and duration of the procedure
  • Specific measurements and imaging findings obtained during the procedure
  • Any additional procedures performed or complications encountered
  • Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93461, ensure that all components of the procedure are performed as described in the official description. Do not report CPT 93461 in conjunction with specific other codes listed in the notes. It is important to follow payer guidelines for reporting this code, including the use of modifiers if necessary. Payers may also split this code into professional and technical components for payment purposes.

8. Historical information

CPT 93461 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 93461

Five similar codes to CPT 93461 include:

  • CPT 93462: 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 right and 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, with complex coronary angiography including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation, when performed.

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