2025 CPT code 93461

Right and left heart catheterization with coronary and bypass graft angiography.

Adhere to all relevant CPT coding guidelines, particularly those for cardiac catheterization procedures. Specific attention must be paid to the detailed descriptions and instructions provided within the CPT manual, along with any updates or clarifications available from AMA.

Modifiers may be applicable depending on the circumstances of the procedure. For example, modifier 26 (professional component) and TC (technical component) may be used depending on the billing entity.Modifiers 59 (distinct procedural service), 51 (multiple procedures), and others may also apply in specific scenarios.

Medical necessity for 93461 is established by the presence of symptoms suggestive of coronary artery disease, valvular heart disease, or other cardiovascular conditions requiring hemodynamic assessment and/or coronary/bypass graft angiography.Documentation must support the clinical indication for the procedure, demonstrating that it is reasonable and necessary for the diagnosis or treatment of the patient's condition.

The physician is responsible for catheter insertion and advancement, hemodynamic measurements, angiography, image interpretation, and overall management of the procedure. This may include pre-procedural preparation, post-procedural care, and interpretation of results to inform patient management.

IMPORTANT Do not report 93461 in conjunction with 33418, 0345T, 0483T, 0484T, 0544T, 0545T, 0643T (for diagnostic coronary angiography or left and right heart catheterization procedures intrinsic to valve repair, annulus reconstruction, or left ventricular restoration device implantation). Do not report 93461 in conjunction with 0408T, 0409T, 0410T, 0411T, 0414T, 0415T.

In simple words: The doctor performs a detailed heart examination using catheters to access and image different heart chambers and blood vessels. This includes checking the coronary arteries and bypass grafts to see how well they are working.Pressure, oxygen levels and other measurements are recorded and analyzed.

This CPT code encompasses the comprehensive procedure of right and left heart catheterization, inclusive of coronary angiography and bypass graft angiography.It involves catheter placement in right-sided (right atrium, right ventricle, pulmonary artery, pulmonary wedge) and left-sided (left atrium, left ventricle) cardiac chambers. Hemodynamic assessments, including pressure measurements, oxygen saturation, and cardiac output (if performed), are included. Intraprocedural injections for angiography of the left ventricle, left atrium, native coronary arteries, and bypass grafts are also inherent to this code. Imaging supervision, interpretation, and reporting are integral components.

Example 1: A patient presents with chest pain and suspected coronary artery disease. The physician performs 93461 to visualize the coronary arteries, assess for blockages, and evaluate left and right ventricular function. Bypass grafts are also assessed., A patient post-coronary artery bypass graft (CABG) surgery experiences recurrent chest pain. The physician performs 93461 to evaluate patency of the bypass grafts and assess for new or worsening coronary artery disease. This would help determine whether further intervention is required., A patient with congenital heart defects undergoes a cardiac catheterization with comprehensive assessment of both left and right sides of the heart. While the primary focus is the congenital anomaly, the assessment of the coronary arteries and bypass grafts also helps determine the overall cardiovascular health of the patient.

Complete history and physical examination, including details of symptoms and past medical history.Informed consent documentation. Pre-procedure and post-procedure EKG.Detailed procedural notes including catheter placement locations, pressure measurements, oxygen saturation values, cardiac output (if performed), and angiographic images with interpretations.Report summarizing findings and recommendations for future management.

** The information provided is for guidance only.Always refer to the most current CPT codebook and payer-specific guidelines for accurate coding and billing practices.Consult with a qualified coding specialist for any questions or uncertainties regarding specific coding scenarios.

  • Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
  • RVU: This information is not available in the provided source and requires reference to a current Relative Value Unit (RVU) database.
  • Global Days : The global period for this procedure is not specified in the provided source and requires reference to payer-specific guidelines.
  • Payment Status: Active
  • Modifier TC rule: Modifier TC (Technical Component) may apply if the facility performs the technical aspects of the procedure separately from the physician’s professional services.
  • Fee Schedule : Historical fee schedule data is not available in the provided source and would need to be obtained from external resources such as Medicare fee schedules or private payer fee schedules.
  • Specialties:Cardiology, Cardiovascular Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center
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