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Congenital Heart Catheterization Coding

Aug 27, 2025

Overview

This lecture covers coding for congenital heart catheterizations, focusing on recent CPT code updates, key documentation points, and procedural distinctions for accurate medical coding.

Importance of Staying Up-to-Date

  • CPT codes for congenital heart catheterizations changed significantly on 12/31/2021 (now 93593–93597).
  • Always verify code information with up-to-date resources, as reputable sources may be outdated.
  • Track annual coding changes and make personal notes for quick reference.

Cardiac Catheterization Coding Basics

  • Cardiac catheterization CPT codes 93454 and 93455 are used for procedures without congenital anomalies.
  • These codes include dye injections, angiograms, catheter placement, repositioning, and interpretation.
  • Congenital heart catheterizations use CPT codes 93593–93597.

Coding Congenital vs. Non-Congenital

  • There are distinct code categories for congenital heart disease versus acquired heart conditions.
  • Codes 93593–93597 are used only when a congenital defect is identified.

Abstracting Documentation for Accurate Coding

  • Key details to extract: congenital vs. non-congenital, normal native connection vs. abnormal native connection.
  • Identify if the procedure was right heart, left heart, or both.
  • Use bubble and highlight techniques in CPT manuals to speed up and improve code selection.

Procedure Overview

  • Procedure often starts with guide wire insertion through femoral vein, moving up to heart chambers.
  • Catheter advances to right atrium, ventricle, and pulmonary arteries for pressure and oxygen measurements.
  • Angiograms are performed and reported separately.

Normal vs. Abnormal Connections

  • Code 93593 for procedures with normal native cardiac connections.
  • Code 93594 for abnormal native cardiac connections in congenital defects.
  • Placement in a morphological left ventricle/atrium can still be coded as right heart cath if entry route was on the right.

Cardiac Output Measurements (93598)

  • 93598 is used for cardiac output measurement studies, billed separately but in conjunction with 93593–93597.
  • Methods include indicator dye or thermal dilution via Swan-Ganz catheter.

Key Terms & Definitions

  • Congenital Heart Defect — A heart abnormality present from birth.
  • Cardiac Catheterization — Insertion of a catheter into the heart to diagnose/treat conditions.
  • Normal Native Connection — Standard anatomical heart vessel connections.
  • Abnormal Native Connection — Anomalous vessel connections due to congenital defects.
  • Swan-Ganz Catheter — Special catheter for measuring cardiac output via thermal or dye dilution.

Action Items / Next Steps

  • Review and annotate CPT codes 93593–93597 in your manual.
  • Research the reasons for right, left, or combined heart catheterizations.
  • Practice abstracting procedure details from sample reports.
  • Brush up on heart and vascular anatomy, especially relating to access sites and great vessels.
  • Submit further topic requests as needed for additional guidance.