How To Use CPT Code 93505

CPT 93505 describes the procedure for endomyocardial biopsy, which involves taking a sample of tissue from within the innermost layer of the heart muscle. 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 93505?

CPT 93505 can be used to describe the procedure for endomyocardial biopsy, which is performed to check for signs of any damage due to rejection of a heart transplant. During this procedure, a sample of tissue is taken from within the innermost layer of the heart muscle for further examination.

2. Official Description

The official description of CPT code 93505 is: ‘Endomyocardial biopsy, including imaging guidance, when performed; right heart.’

3. Procedure

  1. The patient is appropriately prepped and anesthetized for the procedure.
  2. The healthcare provider introduces a biopsy catheter through a femoral vein into the right ventricle of the heart.
  3. The provider takes samples of the heart’s muscle through the catheter.
  4. Imaging guidance may be used during the procedure to ensure accurate placement of the catheter.
  5. The samples are then sent for further examination to check for signs of rejection or other heart diseases.

4. Qualifying circumstances

Endomyocardial biopsy is primarily performed to determine the effectiveness of immunosuppressive therapy after cardiac transplantation. It may also be used to help diagnose other heart diseases. The procedure is typically performed on patients who have undergone a heart transplant or who are suspected of having heart-related conditions that require further evaluation.

5. When to use CPT code 93505

CPT code 93505 should be used when performing an endomyocardial biopsy on the right side of the heart. It is important to accurately document the use of imaging guidance, if performed, as this is included in the code description.

6. Documentation requirements

To support a claim for CPT code 93505, the healthcare provider must document the following information:

  • Indication for the biopsy, such as suspected rejection after cardiac transplantation or other heart-related conditions
  • Details of the procedure, including the use of imaging guidance, if applicable
  • Location of the biopsy (right heart)
  • Any complications or adverse events that occurred during or after the procedure
  • Signature of the healthcare provider performing the biopsy

7. Billing guidelines

When billing for CPT code 93505, ensure that the procedure is performed on the right side of the heart and that imaging guidance, if used, is documented. If the biopsy is performed in conjunction with a diagnostic cardiac catheterization, both CPT code 93505 and the component cardiac catheterization codes should be reported. If the physician performs the cardiac catheterization solely for the purpose of obtaining the biopsy and does not perform a separate diagnostic heart catheterization, only CPT code 93505 should be reported.

8. Historical information

CPT code 93505 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

  1. A patient who has undergone a heart transplant undergoes an endomyocardial biopsy on the right side of the heart to check for signs of rejection.
  2. A patient with suspected heart disease undergoes an endomyocardial biopsy on the right side of the heart to aid in the diagnosis.
  3. A healthcare provider performs an endomyocardial biopsy on the right side of the heart using imaging guidance to ensure accurate placement of the catheter.
  4. A patient who has received immunosuppressive therapy after a heart transplant undergoes a follow-up endomyocardial biopsy on the right side of the heart to assess the effectiveness of the treatment.
  5. A patient with symptoms of heart failure undergoes an endomyocardial biopsy on the right side of the heart to determine the cause of the condition.
  6. A healthcare provider performs an endomyocardial biopsy on the right side of the heart to investigate suspected rejection after a heart transplant.
  7. A patient with a history of heart disease undergoes an endomyocardial biopsy on the right side of the heart to monitor the progression of the condition.
  8. A healthcare provider performs an endomyocardial biopsy on the right side of the heart to rule out any signs of rejection after a recent heart transplant.
  9. A patient with unexplained symptoms undergoes an endomyocardial biopsy on the right side of the heart to aid in the diagnosis of a potential heart-related condition.
  10. A healthcare provider performs an endomyocardial biopsy on the right side of the heart to assess the effectiveness of immunosuppressive therapy in a patient who has undergone a heart transplant.

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