2025 CPT code 93564
Injection procedure during cardiac catheterization for selective opacification of bypass graft(s) to one or more coronary arteries and in situ arterial conduits during congenital heart catheterization.
Modifiers may be applicable to code 93564 to indicate specific circumstances, such as reduced services (modifier 52), distinct procedural service (modifier 59), or other situations as defined by current coding guidelines.
Medical necessity for 93564 must be supported by documentation demonstrating the clinical need for the selective opacification of the bypass graft(s) during the congenital heart catheterization. This might include evaluation of graft patency, assessment of blood flow, or detection of complications.
The physician introduces a catheter into the coronary arteries under fluoroscopic guidance. Dye is injected to visualize blood flow, pressure, and catheter position. Both native arteries and bypass grafts are catheterized, potentially with multiple injections and views. The physician supervises imaging, interprets results, and prepares a report.
In simple words: This procedure involves injecting dye into bypass grafts connected to the heart arteries during a cardiac catheterization in patients with congenital heart disease.The doctor uses this dye to see how well blood is flowing through the grafts. This is done as part of a larger heart catheterization procedure.
Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective opacification of aortocoronary venous or arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary arteries and in situ arterial conduits (eg, internal mammary), whether native or used for bypass to one or more coronary arteries during congenital heart catheterization, when performed (List separately in addition to code for primary procedure).
Example 1: A pediatric patient with Tetralogy of Fallot who has undergone a previous bypass surgery requires a follow-up cardiac catheterization. Code 93564 is used in conjunction with the primary procedure code to report the injection of dye into the bypass graft to visualize blood flow., An infant with Transposition of the Great Arteries has undergone an arterial switch operation and requires a cardiac catheterization. Code 93564 is used in addition to the primary procedure code to report the selective opacification of the bypass graft., A child with a complex congenital heart defect involving multiple prior surgeries and bypass grafts now requires a cardiac catheterization and selective visualization of those grafts. The injections and imaging of the bypass grafts are reported separately with 93564, along with other relevant codes.
Documentation should include details of the cardiac catheterization procedure, including the type and location of bypass grafts, the injection sites, and the interpretation of the imaging results. The report should clearly indicate the use of selective opacification of bypass grafts.
** Code 93564 is for selective opacification, meaning the targeted injection of dye into specific bypass grafts. It does not include imaging of native coronary arteries.