Summary & Overview
CPT 93460: Coronary Angiography with Right and Left Heart Catheterization
CPT code 93460 is a critical billing code in cardiology, representing comprehensive coronary angiography with right and left heart catheterization, often performed in hospital outpatient settings. This procedure is essential for diagnosing and managing complex cardiovascular conditions, including various forms of heart failure and myocardial infarction. Nationally, the code is recognized by major payers such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, ensuring broad coverage for patients undergoing these advanced diagnostic procedures.
This publication provides an in-depth overview of 93460, including its clinical context, typical site of service, and payer coverage. Readers will gain insights into relevant benchmarks, policy updates, and the procedural scope of cardiac catheterization. The summary also highlights associated modifiers and taxonomies, as well as common ICD-10 diagnoses linked to the procedure. By understanding the nuances of 93460, stakeholders can better navigate the complexities of medical billing and reimbursement for cardiac catheterization and related services.
CPT Code Overview
CPT code 93460 represents catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation. This procedure also includes right and left heart catheterization, as well as intraprocedural injection(s) for left ventriculography when performed.
Service Type: Cardiology (Cardiac Catheterization and Associated Procedures)
Typical Site of Service: Hospital Outpatient, such as a Cardiac Catheterization Lab.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the hospital outpatient cardiac catheterization lab with symptoms suggestive of coronary artery disease, heart failure, or myocardial infarction. The patient may have a history of chest pain, shortness of breath, or abnormal cardiac imaging. The cardiologist performs catheter placement in the coronary arteries for coronary angiography, including intraprocedural injections for imaging. Right and left heart catheterization is conducted to assess hemodynamics, and left ventriculography may be performed if indicated. This workflow is used to evaluate the presence and severity of coronary artery disease, cardiac function, and to guide further management.
Coding Specifications
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Modifiers:
26- Professional Component: Used when only the physician's interpretation and report are billed, not the technical portion.TC- Technical Component: Used when only the technical portion (equipment, supplies, and staff) is billed.59- Distinct Procedural Service: Used to indicate that a procedure or service is distinct or independent from other services performed on the same day.51- Multiple Procedures: Used when multiple procedures are performed during the same session.
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Provider Taxonomies: