How To Use CPT Code 93580

CPT 93580 describes the percutaneous transcatheter closure of congenital interatrial communication, such as Fontan fenestration or atrial septal defect, with an implant. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 93580?

CPT 93580 is used to describe the percutaneous transcatheter closure of congenital interatrial communication, such as Fontan fenestration or atrial septal defect, with an implant. This procedure involves the insertion of a catheter through a large vein in the groin and threading it into the right side of the heart. The provider then injects dye and obtains images of the upper and lower chambers of the heart. An implant is then inserted to cover the opening in the septum, or wall between the chambers.

2. Official Description

The official description of CPT code 93580 is: ‘Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant.’

3. Procedure

  1. The provider makes a small incision in the groin and introduces a catheter into the femoral vein.
  2. Under fluoroscopic guidance, the provider advances the catheter over a guide wire into the heart.
  3. The provider injects dye and performs atrial and ventricular angiography to visualize the heart’s blood vessels.
  4. A specialized catheter is advanced across the atrial septal defect from left to right.
  5. The provider exchanges the catheter for a balloon tip catheter and inflates the balloon over the defect to measure it for the implant.
  6. The appropriate size implant is inserted and positioned in the left atrium over the defect.
  7. Fluoroscopy and pressure measurements are used to confirm the position of the implant.
  8. The catheter and any other instruments are withdrawn, and pressure is applied to the wound to control bleeding.

4. Qualifying circumstances

CPT 93580 is performed on patients with congenital interatrial communication, such as Fontan fenestration or atrial septal defect. This procedure is used to close the opening in the interatrial septum, the wall that divides the atrial chambers in the heart. It is important to note that CPT 93580 includes right heart catheterization, angiography, and fluoroscopic guidance, so these procedures should not be reported separately.

5. When to use CPT code 93580

CPT code 93580 should be used when performing the percutaneous transcatheter closure of congenital interatrial communication with an implant. It is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be reported with other codes that are already included in the CPT 93580 description.

6. Documentation requirements

To support a claim for CPT 93580, the provider must document the following information:

  • Patient’s diagnosis and the need for the closure procedure
  • Specific details of the procedure performed, including the type of implant used
  • Date of the procedure
  • Start and end time of the procedure
  • Any additional procedures performed during the same session
  • Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 93580, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The procedure should not be reported with other codes that are already included in the CPT 93580 description. It is also important to follow any additional guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 93580 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition. It is important to stay updated with any changes or revisions to the code in future code sets.

9. Examples

  1. A provider performs percutaneous transcatheter closure of an atrial septal defect with an implant for a patient with a congenital heart defect.
  2. A patient with Fontan fenestration undergoes percutaneous transcatheter closure of the communication between the atria using an implant.
  3. A provider performs percutaneous transcatheter closure of a patent foramen ovale with an implant for a patient with a history of stroke.
  4. A congenital interatrial communication is closed percutaneously using an implant for a patient with a complex congenital heart defect.
  5. A provider performs percutaneous transcatheter closure of an atrial septal defect with an implant for a pediatric patient with symptoms of heart failure.
  6. A patient with a congenital interatrial communication undergoes percutaneous transcatheter closure using an implant to prevent the risk of embolism.
  7. A provider performs percutaneous transcatheter closure of a Fontan fenestration with an implant for a patient with cyanosis and exercise intolerance.
  8. A patient with an atrial septal defect undergoes percutaneous transcatheter closure using an implant to reduce the risk of recurrent respiratory infections.

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