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CPT 93587: Venovenous Collateral Vein Imaging During Heart Catheterization

CPT code 93587 captures catheter-directed vein imaging conducted at the same session as a heart catheterization to evaluate venovenous collaterals originating at or above the heart in patients with congenital cardiac defects. This code matters nationally because it documents a focused intraprocedural diagnostic assessment that can influence procedural decision-making, resource use in catheterization laboratories, and downstream care planning for congenital heart disease.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, typical sites of service, and the service type. The publication outlines commonly reported modifiers and payer considerations where available, presents benchmark and coverage patterns when reported by payers, and summarizes policy and coding guidance relevant to intraprocedural imaging during congenital heart catheterization. The content is intended for billing professionals, clinical coders, and policy analysts seeking a national-level understanding of how CPT code 93587 is used and reimbursed across major payers.

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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Billing Code Overview

CPT code 93587 describes intra-procedural vein imaging performed during the same session as a heart catheterization for one or more congenital cardiac defects. The procedure specifically assesses venovenous collaterals that originate at or above the heart using a catheter-based imaging technique.

Service type: Catheter-based diagnostic or imaging procedure performed in conjunction with congenital heart catheterization
Typical site of service: Hospital cardiac catheterization laboratory or specialized interventional cardiology suite

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CPT 93587: Venovenous Collateral Vein Imaging During Heart Catheterization

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

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Billing Code Overview

Service type: Catheter-based diagnostic or imaging procedure performed in conjunction with congenital heart catheterization
Typical site of service: Hospital cardiac catheterization laboratory or specialized interventional cardiology suite

Clinical & Coding Specifications

Clinical Context

A pediatric patient with known congenital heart disease (for example, single-ventricle physiology after staged palliation) is brought to the cardiac catheterization laboratory for diagnostic catheterization and evaluation of suspected venovenous collaterals contributing to hypoxemia or cyanosis. Under monitored anesthesia care or general anesthesia, the interventional cardiology team performs standard right and/or left heart catheterization to measure pressures and oxygen saturations. At the same session as the heart catheterization, a catheter-based venous angiographic study is performed to image venovenous collateral vessels that originate at or above the heart, using contrast injection via a venous catheter, fluoroscopic imaging, selective catheter manipulation, and digital subtraction angiography as indicated. The workflow includes preprocedure verification, vascular access (commonly femoral or jugular venous access), selective catheter placement into suspected collateral source veins, contrast injections to outline collaterals, hemodynamic measurements, documentation of findings, and determination of whether additional interventions (for example, coil or device occlusion) are required. Postprocedure monitoring occurs in a recovery unit with attention to hemodynamics, access site care, and oxygenation. Billing captures the imaging of venovenous collaterals performed at the same session as heart catheterization using 93587.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s professional component separate from facility technical services, if applicable.
`52`	Reduced services	Use when the service is partially reduced or not completed as described, with documentation of reason and extent.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to patient-related or emergent circumstances.
`59`	Distinct procedural service	Use to indicate a separate and distinct service if another procedure on a different site or session is billed that might be bundled.
`62`	Two surgeons	Use when two surgeons of different specialties actively perform portions of the procedure requiring shared operative responsibility.
`78`	Unplanned return to the OR by same physician following initial procedure	Use when a return to the operating room for related services occurs during the postoperative period.
`80`	Assistant surgeon present	Use when a surgical assistant is documented as providing assistant-at-surgery services.
`82`	Assistant surgeon (when a qualified resident surgeon not available)	Use when an assistant surgeon is required and a resident is not available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for Medicare	Use when the service was performed by or incident to an eligible non-physician practitioner under Medicare rules.
`59`	Distinct procedural service	Use when services that are normally bundled are separate and distinct by anatomy or session (duplicate shown here intentionally for emphasis in specific billing contexts).

Taxonomy Code	Specialty	Notes
208M00000X	Pediatric Cardiology	Interventional pediatric cardiologists frequently perform congenital heart catheterizations and venous collateral assessments.
207RC0000X	Interventional Cardiology	Adult interventional cardiologists who manage congenital heart disease in adults (grown-up congenital heart disease) may perform this imaging.
207K00000X	Cardiovascular Disease	General cardiologists with catheterization privileges involved in structural/ congenital assessments.
363A00000X	Physician Assistant	PAs frequently assist in the catheterization laboratory and may bill incident-to or supervised services depending on payer rules.
163W00000X	Registered Nurse Anesthetist	Involvement for anesthesia care during catheterization when required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q20.0`	Common arterial trunk	Congenital cardiac anomaly that may be associated with venous abnormalities and need for catheter-based evaluations including collateral imaging.
`Q21.1`	Atrial septal defect	Patients with residual shunts or staged repairs can develop venovenous collaterals contributing to desaturation.
`Q22.0`	Persistent pulmonary hypertension of the newborn	May prompt evaluation of venous anatomy and collaterals in the context of complex cardiopulmonary physiology.
`Q23.4`	Single ventricle	Single-ventricle physiology after palliation commonly requires catheter-based assessment for collaterals that worsen systemic oxygenation.
`I27.9`	Pulmonary heart disease, unspecified	In select cases of pulmonary vascular disease, venovenous collaterals are assessed to evaluate abnormal venous return affecting oxygenation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93452`	Right and left heart catheterization including intraprocedural injections for left ventriculography, when performed	Often performed immediately before `93587` to obtain pressures, saturations, and cardiac anatomy prior to venovenous collateral imaging.
`93458`	Transcatheter placement of a device for atrial septal defect or patent foramen ovale closure (including imaging guidance)	May be performed in the same session if anatomic findings indicate concurrent structural intervention following diagnostic imaging.
`93580`	Catheter placement, pulmonary artery for measurement and injection of contrast material	May be performed in the same catheterization session as part of comprehensive venous and pulmonary vascular assessment.
`93566`	Endovascular transcatheter embolization or occlusion of venous collaterals, coronary, or systemic veins	Performed after imaging when therapeutic occlusion of identified venovenous collaterals is indicated.
`93799`	Unlisted cardiovascular service or procedure	Used when a specific, atypical venous imaging or combined complex procedure does not have a precise CPT code and additional documentation is provided.

CPT 93586: Coronary Sinus Imaging During Heart Catheterization for Congenital Defects

CPT-93593-RIGHT-HEART-CATHETERIZATION-CONGENITAL-HEART-DISEASE

CPT 93593: Right Heart Catheterization for Congenital Heart Defects

CPT-93594-DIAGNOSTIC-CARDIAC-CATHETERIZATION-CONGENITAL-HEART-DEFECTS

CPT 93594: Diagnostic Cardiac Catheterization for Congenital Heart Defects

CPT-93595-LEFT-SIDED-DIAGNOSTIC-CARDIAC-CATHETERIZATION-CONGENITAL

CPT 93595: Left-Sided Diagnostic Cardiac Catheterization for Congenital Heart Defect

CPT-93596-DIAGNOSTIC-RIGHT-LEFT-HEART-CATHETERIZATION-CONGENITAL

CPT 93596: Diagnostic Right and Left Heart Catheterization in Congenital Heart Disease

CPT-93597-CONGENITAL-HEART-CATHETERIZATION-BILATERAL-SAMPLING

CPT 93597: Diagnostic Cardiac Catheterization for Congenital Heart Defects

CPT-93598-CARDIAC-OUTPUT-MEASUREMENT-CONGENITAL-CATHETERIZATION

CPT 93598: Cardiac Output Measurement During Congenital Catheterization

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s professional component separate from facility technical services, if applicable.
`52`	Reduced services	Use when the service is partially reduced or not completed as described, with documentation of reason and extent.
`53`	Discontinued procedure	Use when the procedure is started but terminated due to patient-related or emergent circumstances.
`59`	Distinct procedural service	Use to indicate a separate and distinct service if another procedure on a different site or session is billed that might be bundled.
`62`	Two surgeons	Use when two surgeons of different specialties actively perform portions of the procedure requiring shared operative responsibility.
`78`	Unplanned return to the OR by same physician following initial procedure	Use when a return to the operating room for related services occurs during the postoperative period.
`80`	Assistant surgeon present	Use when a surgical assistant is documented as providing assistant-at-surgery services.
`82`	Assistant surgeon (when a qualified resident surgeon not available)	Use when an assistant surgeon is required and a resident is not available.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for Medicare	Use when the service was performed by or incident to an eligible non-physician practitioner under Medicare rules.
`59`	Distinct procedural service	Use when services that are normally bundled are separate and distinct by anatomy or session (duplicate shown here intentionally for emphasis in specific billing contexts).

Taxonomy Code	Specialty	Notes
208M00000X	Pediatric Cardiology	Interventional pediatric cardiologists frequently perform congenital heart catheterizations and venous collateral assessments.
207RC0000X	Interventional Cardiology	Adult interventional cardiologists who manage congenital heart disease in adults (grown-up congenital heart disease) may perform this imaging.
207K00000X	Cardiovascular Disease	General cardiologists with catheterization privileges involved in structural/ congenital assessments.
363A00000X	Physician Assistant	PAs frequently assist in the catheterization laboratory and may bill incident-to or supervised services depending on payer rules.
163W00000X	Registered Nurse Anesthetist	Involvement for anesthesia care during catheterization when required.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q20.0`	Common arterial trunk	Congenital cardiac anomaly that may be associated with venous abnormalities and need for catheter-based evaluations including collateral imaging.
`Q21.1`	Atrial septal defect	Patients with residual shunts or staged repairs can develop venovenous collaterals contributing to desaturation.
`Q22.0`	Persistent pulmonary hypertension of the newborn	May prompt evaluation of venous anatomy and collaterals in the context of complex cardiopulmonary physiology.
`Q23.4`	Single ventricle	Single-ventricle physiology after palliation commonly requires catheter-based assessment for collaterals that worsen systemic oxygenation.
`I27.9`	Pulmonary heart disease, unspecified	In select cases of pulmonary vascular disease, venovenous collaterals are assessed to evaluate abnormal venous return affecting oxygenation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93452`	Right and left heart catheterization including intraprocedural injections for left ventriculography, when performed	Often performed immediately before `93587` to obtain pressures, saturations, and cardiac anatomy prior to venovenous collateral imaging.
`93458`	Transcatheter placement of a device for atrial septal defect or patent foramen ovale closure (including imaging guidance)	May be performed in the same session if anatomic findings indicate concurrent structural intervention following diagnostic imaging.
`93580`	Catheter placement, pulmonary artery for measurement and injection of contrast material	May be performed in the same catheterization session as part of comprehensive venous and pulmonary vascular assessment.
`93566`	Endovascular transcatheter embolization or occlusion of venous collaterals, coronary, or systemic veins	Performed after imaging when therapeutic occlusion of identified venovenous collaterals is indicated.
`93799`	Unlisted cardiovascular service or procedure	Used when a specific, atypical venous imaging or combined complex procedure does not have a precise CPT code and additional documentation is provided.

CPT 93586: Coronary Sinus Imaging During Heart Catheterization for Congenital Defects

CPT-93593-RIGHT-HEART-CATHETERIZATION-CONGENITAL-HEART-DISEASE

CPT 93593: Right Heart Catheterization for Congenital Heart Defects

CPT-93594-DIAGNOSTIC-CARDIAC-CATHETERIZATION-CONGENITAL-HEART-DEFECTS

CPT 93594: Diagnostic Cardiac Catheterization for Congenital Heart Defects

CPT-93595-LEFT-SIDED-DIAGNOSTIC-CARDIAC-CATHETERIZATION-CONGENITAL

CPT 93595: Left-Sided Diagnostic Cardiac Catheterization for Congenital Heart Defect

CPT-93596-DIAGNOSTIC-RIGHT-LEFT-HEART-CATHETERIZATION-CONGENITAL

CPT 93596: Diagnostic Right and Left Heart Catheterization in Congenital Heart Disease

CPT-93597-CONGENITAL-HEART-CATHETERIZATION-BILATERAL-SAMPLING

CPT 93597: Diagnostic Cardiac Catheterization for Congenital Heart Defects

CPT-93598-CARDIAC-OUTPUT-MEASUREMENT-CONGENITAL-CATHETERIZATION

CPT 93598: Cardiac Output Measurement During Congenital Catheterization

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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CPT 93587: Venovenous Collateral Vein Imaging During Heart Catheterization

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Billing Code Overview

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CPT 93587: Venovenous Collateral Vein Imaging During Heart Catheterization

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References