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2025 CPT code 93585

Venography of the azygos/hemiazygos venous system during a congenital heart catheterization procedure.

This is an add-on code and should be reported only with a primary cardiac catheterization code for congenital heart defects. Report once per session.

Modifiers may be applicable depending on the specific circumstances of the procedure and the payer requirements.Consult your payer's guidelines.

Venography of the azygos/hemiazygos system is medically necessary when assessing the venous drainage pathways and determining the surgical approach or assessing collateral circulation in patients with congenital heart defects.

The cardiologist or interventionalist is responsible for catheter placement, contrast injection, image acquisition, and interpretation of the venogram of the azygos/hemiazygos venous system. The radiologist may be involved in image interpretation depending on the facility's workflow and physician relationships.

IMPORTANT:This code is used in conjunction with primary cardiac catheterization codes for congenital heart defects (93593, 93594, 93596, 93597).It's reported once per session. Other related codes include 93584 (anomalous SVC), 93586 (coronary sinus), 93587 (venovenous collaterals above heart), and 93588 (venovenous collaterals below heart).

In simple words: This test uses X-rays and dye to take pictures of the blood flow in specific veins in the chest (azygos and hemiazygos veins). This is done at the same time as another heart procedure to check for problems.

This CPT code, 93585, represents venography of the azygos/hemiazygos venous system performed during the same session as cardiac catheterization for one or more congenital heart defects.The procedure involves catheter placement in the azygos and hemiazygos veins, contrast injection, image acquisition, and radiological supervision and interpretation.It is an add-on code and must be reported in addition to the primary cardiac catheterization code (93593, 93594, 93596, or 93597).

Example 1: A patient with Tetralogy of Fallot undergoes cardiac catheterization. During the procedure, the physician notes the need to assess the azygos/hemiazygos system's patency, which is coded with 93585, in addition to the primary catheterization code., A patient with a complex congenital heart anomaly requiring multiple surgical repairs has a follow-up cardiac catheterization with venography. The physician images and assesses the azygos/hemiazygos venous system's anatomy to rule out any collateral venous circulation, and this is coded appropriately., A patient with total anomalous pulmonary venous return (TAPVR) needs a cardiac catheterization and venogram to map out the venous system prior to planning surgery. The venogram includes assessment of the azygos/hemiazygos system, which is coded using 93585.

** This code is intended to describe venography of the azygos/hemiazygos venous system, which is often required for comprehensive evaluation of complex congenital heart disease.

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