Ask Dr. Z

My provider performed coronary angiography, bypass graft angiography, and cinefluoroscopy of mechanical prosthetic aortic valve as follows: "Left wrist catheterized with 11F. Diagnostic coronary angiograms performed in multiple projections....(findings then delineated). Cath used to cannulate LIMA graft to LAD for angiograms....(findings then delineated). I performed cinefluoroscopy of mechanical prosthetic aortic valve and was only able to visualize one leaflet moving as expected. Second leaflet was not mobile or visualized in any view. I became concerned that he had partial prosthetic thrombosis...." As this point, another provider entered the cath lab to perform TEE, and the procedure continued on from there. Am I able to submit 93455 with 76000 for the prosthetic valve fluoroscopy, or is the 76000 included in the 93455? CodeCorrect says it is billable with a modifier, but I do not know whether this would constitute a situation where that would be appropriate.