How To Use CPT Code 93581

CPT 93581 describes the percutaneous transcatheter closure of a congenital ventricular 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 93581?

CPT 93581 can be used to describe the percutaneous transcatheter closure of a congenital ventricular septal defect with an implant. This code is used when a healthcare provider inserts a catheter through a large vein in the groin and threads 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. Finally, an implant is inserted to cover the opening in the septum, or wall between the chambers.

2. Official Description

The official description of CPT code 93581 is: ‘Percutaneous transcatheter closure of a congenital ventricular septal defect with implant.’

3. Procedure

1. The healthcare 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 obtain images of the heart chambers.
4. A catheter with a folded-up umbrella-like device is inserted into the septum.
5. The provider positions the device to plug the hole between the ventricles and secures it in place.
6. The catheter is withdrawn, and pressure is applied to the wound to prevent bleeding.

4. Qualifying circumstances

Patients eligible for CPT 93581 are those with a congenital ventricular septal defect that requires closure. This procedure is performed by a healthcare provider using a percutaneous transcatheter approach. The provider must perform right heart catheterization, angiography, and fluoroscopic guidance during the procedure. Other cardiac angiographic procedures performed at the same time should be reported separately using appropriate codes.

5. When to use CPT code 93581

CPT code 93581 should be used when a healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant. This code should not be reported separately if other cardiac angiographic procedures are performed at the same time. It is important to review the documentation and determine if additional codes are necessary for a complete and accurate billing.

6. Documentation requirements

To support a claim for CPT 93581, the healthcare provider must document the following information:

• Patient’s diagnosis of a congenital ventricular septal defect
• Description of the procedure performed, including the use of percutaneous transcatheter closure and implant
• Date of the procedure
• Details of the right heart catheterization, angiography, and fluoroscopic guidance
• Any additional cardiac angiographic procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 93581, ensure that the procedure meets the criteria for percutaneous transcatheter closure of a congenital ventricular septal defect with an implant. The documentation should support the use of right heart catheterization, angiography, and fluoroscopic guidance. It is important to review the documentation and determine if additional codes are necessary for a complete and accurate billing. Other cardiac angiographic procedures performed at the same time should be reported separately using appropriate codes.

8. Historical information

CPT 93581 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant, using right heart catheterization, angiography, and fluoroscopic guidance.
2. A patient with a congenital ventricular septal defect undergoes percutaneous transcatheter closure with an implant, including atrial and ventricular angiograms.
3. A healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant, using a percutaneous approach and fluoroscopic guidance.
4. A patient with a congenital ventricular septal defect undergoes percutaneous transcatheter closure with an implant, including right heart catheterization and angiography.
5. A healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant, using a percutaneous approach and atrial angiography.
6. A patient with a congenital ventricular septal defect undergoes percutaneous transcatheter closure with an implant, including ventricular angiography and fluoroscopic guidance.
7. A healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant, using right heart catheterization and fluoroscopic guidance.
8. A patient with a congenital ventricular septal defect undergoes percutaneous transcatheter closure with an implant, including atrial angiography and fluoroscopic guidance.
9. A healthcare provider performs percutaneous transcatheter closure of a congenital ventricular septal defect with an implant, using atrial and ventricular angiograms and fluoroscopic guidance.
10. A patient with a congenital ventricular septal defect undergoes percutaneous transcatheter closure with an implant, including right heart catheterization and atrial angiography.