Basics of CPT code 93594, 93595, 93596, 93597 & 93598
New codes are added for congenital heart catheterizations. The old codes 93530-93539 were deleted. The new codes are based on normal vs abnormal native connections. In Normal native connections blood flows along the expected course through the right and left heart chambers and the great vessels. In Abnormal native connections alternative connections for the pathway of blood flow through the heart and great vessels, typically patients with cyanotic defects. Cardiac catheterization for the evaluation of congenital heart defect(s) is reported with CPT code 93593, 93594, 93595, 93596, 93597, 93598.
Description of CPT code 93594, 93595, 93596, 93597 & 93598
The physician performs a right heart catheterization for congenital cardiac anomalies. The physician investigates congenital cardiac anomalies by measuring pressures, taking blood samples for oximetry, and/or injecting contrast to assess chamber size and function. The physician places an introducer sheath in a vein (typically, the femoral vein) using percutaneous puncture. The physician places a lumen catheter through the introducer sheath into the femoral vein and advances it, under fluoroscopic guidance, to the heart chamber receiving venous circulation. The physician may use the fluid-filled catheter to record intracardiac pressures, withdraw blood samples, or inject radiopaque contrast material. The physician removes the catheter and sheath from the femoral vein. Pressure is placed on the wound for 20 to 30 minutes to stem bleeding. CPT code 93593 is reported for a procedure performed on a patient with normal native connections and CPT code 93594 for a patient whose native connections are abnormal.
93593 Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections
93594 abnormal native connections
The physician performs a left heart catheterization to evaluate a congenital heart defect. A catheter is threaded to the heart, most frequently through an introducing sheath placed percutaneously into the femoral, brachial, or axillary artery using retrograde technique. Using this technique, the catheter progresses through either normal or abnormal connections into the left ventricle or left atrium. Intracardiac and intravascular pressures are recorded. Left ventriculography or left atrial angiography may be performed and is reported separately; the physician injects dye through a previously placed catheter threaded through a central line into the left ventricle or atrium to evaluate function with fluoroscopy. Imaging guidance used to advance the catheter to the targeted area is included in this CPT code 93595.
93595 Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections
The physician performs combined right and left heart catheterization to investigate congenital cardiac anomalies. The physician places an introducer sheath in a vein (typically, the femoral vein) using percutaneous puncture. The physician places a lumen catheter through the introducer sheath into the femoral vein and advances it, under fluoroscopic guidance, to the heart chamber receiving venous circulation. The physician places an introducer sheath in an artery (typically, the femoral artery) using percutaneous puncture. The physician places a lumen catheter through the introducer sheath into the femoral artery and advances it, under fluoroscopic guidance, through the aorta to the heart chamber providing arterial circulation. The physician may use the fluid filled catheters to record intracardiac pressures, withdraw blood samples, or inject radiopaque contrast material. The physician removes the catheters and sheaths from the femoral vessels. Pressure is placed on the wound for 20 to 30 minutes to stem bleeding. CPT code 93596 for a procedure performed on a patient with normal native connections and CPT code 93597 for a patient whose native connections are abnormal.
93596 Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections
93597 abnormal native connections
Indicator dilution studies use a technique based on the principle that the volume of a fluid within a container can be determined by adding a known quantity of an indicator to the fluid and measuring the concentration of the indicator after it has completely mixed with the fluid. A time-concentration curve arises and the area of the inscribed curve is calculated. The physician threads a catheter through a central line leading to the heart and dye, such as nontoxic, water-soluble indocyanine green, or a thermal indicator, usually iced saline, is injected. In the thermodilution method, cardiac output is measured by a computer using an equation that incorporates body temperature, injection volume and temperature, time, and other calculated ratios over a denominator of the integral of the change in blood temperature during the cold injection, reflected by the area of the inscribed curve. This procedure is performed during a cardiac catheterization for the evaluation of congenital heart defects.
+93598 Cardiac output measurement(s), thermodilution or other indicator dilution method, performed during cardiac catheterization for the evaluation of congenital heart defects (List separately in addition to code for primary procedure)
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