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Right atrial Fontan conduit catheterization and pressure measurement coding

Date: Apr 24, 2019

Question:

"Congenital heart disease status post extracardiac Fontan procedure now with chronic hyperbilirubinemia and lesion seen on CT. Concern for hepatic cirrhosis. Anatomy is not favorable for a transjugular liver biopsy. IR consulted for hepatic venogram with pressures. Left femoral vein access. Catheter used to select second order branch of right hepatic vein with subsequent venography that demonstrated a normal patent hepatic vein without stenosis. Catheter was exchanged for occlusion balloon catheter that was utilized to obtain free (14 mmHg) and wedged (16 mmHg) hepatic venous pressures. The catheter was then withdrawn and advanced into the right atrial Fontan conduit. Angiography showed antegrade flow, and pressure (15 mmHg) was also obtained. Finally, the catheter was withdrawn into the intrahepatic inferior vena cava, and venography showed antegrade flow with pressure measurement (15 mmHg) performed. Catheter was removed and hemostasis obtained." Is this procedure reported with codes 36012, 75889, 75825, 36013, and 76496? Or should I report codes 36012, 75889, 75825, and 93530?

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