2025 CPT code 93595
(Active) Effective Date: N/A Revision Date: N/A Cardiology - Cardiac Catheterization Medicine/Cardiovascular/Cardiac Catheterization for Congenital Heart Defects Feed
Left heart catheterization for congenital heart defects, encompassing imaging guidance for catheter advancement to the target area, applicable to both normal and abnormal native connections.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., multiple procedures, professional component).Consult the CPT coding manual and the NCCI edits for appropriate modifier usage.
Medical necessity is established when there is a clinical indication for evaluating the anatomy and physiology of the left side of the heart in a patient with known or suspected congenital heart disease.This may be for diagnostic purposes (to confirm a diagnosis or assess the severity of a defect) or for evaluating the success of previous interventions.
The cardiologist or interventional cardiologist is responsible for performing the procedure.This includes accessing a blood vessel (typically in the groin or arm), advancing the catheter to the left heart chambers under imaging guidance, performing hemodynamic assessments as needed, and managing any complications.
- Medicine/Cardiovascular/Cardiac Catheterization for Congenital Heart Defects
- Cardiac Catheterization for Congenital Heart Defects
In simple words: This code describes a heart test where a thin, flexible tube (catheter) is guided to the left side of the heart to check for birth defects.Pictures (like X-rays) are used to guide the tube, and the doctor will check the heart's blood flow.This test is done for people born with heart problems.
This CPT code, 93595, represents left heart catheterization (LHC) performed to evaluate congenital heart defects.The procedure includes catheter placement in one or more left-sided cardiac chambers (left ventricle or left atrium), utilizing imaging guidance (fluoroscopy or ultrasound) by the proceduralist to advance the catheter to the target area.Hemodynamic evaluations, such as pressure measurements and blood flow assessments, may be performed. This code is applicable regardless of whether the patient presents with normal or abnormal native connections. If the morphologic right ventricle or atrium is connected to the aorta due to a congenital anomaly, catheter placement in these subaortic structures is considered part of LHC for coding purposes. The code does not encompass left ventricular/left atrial angiography, transapical puncture of the left ventricle, or transseptal puncture of an intact septum; these are separately reported. Imaging supervision, interpretation, and report are included.
Example 1: A 2-year-old child with a suspected ventricular septal defect undergoes left heart catheterization to confirm the diagnosis and assess the severity of the defect., A 15-year-old patient with a history of transposition of the great arteries undergoes left heart catheterization to evaluate hemodynamics and assess for residual shunts., An adult patient with complex congenital heart disease, including tetralogy of Fallot, undergoes left heart catheterization to evaluate the patency and function of previous surgical repairs.
Pre-procedure history and physical examination, including details of congenital heart defects,imaging studies (echocardiogram, CT, MRI) if available, consent form, intraoperative hemodynamic data (pressure measurements, oxygen saturations), fluoroscopy images, post-procedure nursing notes, and the final report with interpretation.
** Accurate coding requires a thorough understanding of the patient's anatomy, the specifics of the procedure performed, and the applicable CPT coding guidelines.Proper documentation is essential for appropriate reimbursement.
- Payment Status: Active
- Modifier TC rule: The technical component modifier (TC) is typically not applicable to this code as it is generally considered a professional service.
- Fee Schedule: Fee schedules vary by payer and geographic location.Consult your payer's fee schedule or a commercial pricing database for historical and current fee information.
- Specialties:Cardiology, Interventional Cardiology, Pediatric Cardiology, Congenital Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center