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Patient presents for RHC (93451-26) & EMB (93505-26) s/p heart transplant w/possible re-intervention on pulmonary veins. Both right/left PA wedge angiography performed to eval pulmonary venous return on levophase. Hand injection done with catheters placed in left lower branch of LPA, main LPA to evaluate the LLPV, RLPV, RMPV, Left lingular pulmonary vein. Findings: right sided pressures were reasonable, PA wedge angiography showed mild-moderate stenosis in left lower and right lower pulmonary veins on levophase with PCWP being 16-17 mmHg. Stenosis appeared to be stable compared to post-angioplasty angiography at the last cath. Therefore, we decided to leave those alone.

I don't feel that billing 93568/93569 is appropriate since not looking at the pulmonary arteries. Can we bill for selective placement 36014 for placement in LPA and 75746 for the S&I to look at the veins? Thank you.