Where Anesthesia Coders Go Wrong With CS Cath Placement

Posted on 16. Jun, 2009 by Editor in Hot Coding Topics

Your doc needs to do this to get paid on more than CS cath placement.

Quick — look up the CPT code for coronary sinus (CS) catheter placement used during cardiac surgery. No luck? Then an unlisted code reporting is in your future. Coding News is here to bust 3 myths that may fool you into selecting the wrong anesthesia code for this procedure:

Myth 1: Code 93508 Applies to CS Cath

Fact: Code 93508 (Catheter placement in coronary artery[s], arterial coronary conduit[s], and/or venous coronary bypass graft[s] for coronary angiography without concomitant left heart catheterization) does not apply to coronary sinus catheter placement, even if you append modifier 52 (Reduced services). In addition, the 936xx range of codes (those for EP studies) are inappropriate. Instead, an unlisted code is your best choice.

Anesthesiologists insert coronary sinus catheters for minimally invasive heart valve surgery, says Farhan Sheikh, MD, professor of anesthesiology and director of cardiac anesthesia at Albany Medical Center. “The coronary sinus is inserted with a catheter to deliver retrograde cardioplegia solution with TEE guidance, not for monitoring or angiography purposes.”

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Coronary sinus pressure is monitored when the retrograde cardioplegia solution is being injected into it, but not for any other reason. Although many centers still perform the procedure, there are now less invasive means to accomplish the same patient safety goals.

Myth 2: Cath Intro Is Way to Go

An ASA teleconference in Nov. of 2008 recommended 36013 (Introduction of catheter, right heart or main pulmonary artery) for this CS cath placement. Joanne Mehmert, CPC, an independent consultant from Kansas City, Mo., disagrees, saying that currently, no...

Tags: 36013, 93508, 93799, anesthesia, coronary sinus catheter placement, CS cath placement, guidance, modifier 52, unlisted code