Ask Dr. Z

Can you give us more information on when to use the congenital heart cath codes? Are all hospitals required to use the congenital codes? For example, an echo is performed with findings suggestive of PLSVC with RV overload. Patient also had coronary CTA with CardioScore of 210. RHC was performed to assess pulmonary pressures given RV dilation. No coronaries were imaged, but pressures were obtained in the RA, RV, PA, and PCW positions. TD cardiac outputs were obtained. A PA and a PCW oxygen saturation were used to calculate Fick cardiac output. Saturations were obtained for full shunt run in the SVC, IVC, RA, RV, PA, pulmonary wedge positions. Can we code this as 93451, or should we use the congenital codes? I am not finding much information out there about these congenital codes.