2025 CPT code 93596
Effective Date: N/A Medicine - Cardiovascular Feed
Combined right and left heart catheterization for congenital heart defect(s), normal native connections.
Modifiers may be applicable, including 22 (increased procedural services), 26 (professional component), 52 (reduced services), 53 (discontinued procedure), 59 (distinct procedural service), and others as appropriate.
Medical necessity must be established by documenting the patient’s congenital heart defect, the clinical question to be answered by the catheterization, and how the results will guide management decisions.
The physician prepares the patient, gains vascular access, introduces the catheter(s), and uses imaging guidance to advance them to the target areas in the heart. They obtain blood samples, may perform hemodynamic evaluations and cardiac output measurements, and then remove the catheters and ensure proper closure of the access sites.
In simple words: For a patient born with one or more heart defects and normal blood flow connections, the doctor inserts small, flexible tubes (catheters) into both sides of the heart to examine its function and take blood samples. This helps to understand the heart’s condition and plan treatment.
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. This code is specific to combined RHC and LHC in a patient with one or more congenital heart defects and normal native connections, meaning blood flow follows the expected course through the heart chambers and great vessels. The procedure involves accessing the right and left sides of the heart with catheters, obtaining blood samples to measure blood gases, and optionally performing Fick cardiac output measurements.Transapical puncture of the left ventricle or transseptal puncture of an intact septum for LHC is reported separately.
Example 1: A newborn with an atrial septal defect undergoes combined right and left heart catheterization to assess the size and location of the defect and measure blood oxygen levels and flow., A child with a ventricular septal defect has this procedure to evaluate the defect's impact on heart function and pulmonary artery pressure., A patient with a patent ductus arteriosus undergoes combined catheterization to assess the size and flow through the ductus and determine the need for closure.
Documentation should include the indication for the procedure, details of the catheterization process (access sites, catheters used, structures accessed), hemodynamic measurements obtained, blood gas results, and any complications encountered.
- Revenue Code: P2F
- Specialties:Pediatric Cardiology, Interventional Cardiology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center