Ask Dr. Z

When is it appropriate to bill codes 76377 for 3D and 93612 for ventricular pacing when performed during rotational angiography along with pulmonary artery angioplasty (92997)?

"Example: Patient presents for a diagnostic cardiac cath and possible intervention on the conduit. Complete right heart and retrograde left heart cath was performed. 6 French Berman angiographic cath was placed in the right ventricle. A 4 French pacing cath was inserted in the LFV sheath and placed in the right ventricle. Right ventricular pacing was performed at 180/min with breath hold, and rotational angiography was performed. Rendering and post-processing of the rotational images was performed. After post-processing, the image was used for overlay on the fluoroscopy. Angioplasty was then performed within the RV-PA conduit and the right pulmonary artery. There was adequate arborization bilaterally. Post angiography demonstrated adequate relief of the stenosis. Improved angiographic appearance of the RPA post balloon angioplasty with no evidence of vascular injury."