Ask Dr. Z

"Patient presents for stage 2 of staged PCI. After approximately 10 balloon inflations, several balloon exchanges, and three Shockwave therapies of 20 pulses each on a heavily calcified area of the LC, patient developed slow flow and changes in ST segments. Expo cath was advanced across patient’s Sapien 3 valve (only 2 months old) into LT vent and hemodynamic data was collected. PCI on LC continued, with no mention of removal of the LT heart cath." Hemodynamic data was entered into the log, but was not included in dictated report. Can this LT heart cath legitimately be coded with 93452-XU? My feeling is that this seems to have been done for monitoring purposes and in response to a physician-caused indication, so it should not be coded. Cath lab tech makes a case that it was medically necessary and probably done to check overall function and see if additional support would be needed. Eager to hear your thoughts on this, as we find no published precedent for use of 93452 in this way.