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Old answers (ID:14602 & 3515) to this question state to use 93799. However, the 2022 Z ref book pg 176 says that since non-cong. heart cath codes are in the parentheticals as not reportable with 93581 that may indicate the use of 93581 for percutaneous VSD closure of a post MI VSD. in this case should we code the heart cath and unlisted for the closure or just the closure that bundles the heart cath? Case: H/O MI; treated with PCI (3 stents); noted to have a ventricular septal rupture the next day and went into CHF.S/P surgical patch closure of the VSR/VSD. Pre: Moderate to large residual VSR/VSD at the superior margin of the previously placed VSD patch, minimal diameter 13-16mm. Right and left heart cath performed, LV angio done. 18mm occluder device placed. Post:Small residual shunt through the VSD device, no additional VSR/VSD is noted.