Summary & Overview
HCPCS C7558: Coronary and Bypass Graft Angiography with Hemodynamic Assessment
HCPCS Level II code C7558 represents an extensive diagnostic cardiac catheterization service that combines coronary angiography, right and left heart catheterization (including left ventriculography when performed), bypass graft angiography, pharmacologic agent administration, and hemodynamic monitoring. This code matters nationally because it captures a high-acuity, resource-intensive procedure central to diagnosis and management of ischemic and hemodynamic cardiac conditions, and it affects hospital and outpatient cardiology billing and utilization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical scope and service setting, benchmarking points relevant to utilization and claims coding, common billing considerations, and policy or coverage themes that typically influence reimbursement and prior authorization. The publication also outlines typical modifiers and documentation elements associated with complex cardiac catheterization services. Where specific input data is missing, the text notes that such details are not available in the input.
This summary provides clinicians, billing professionals, and policy analysts with the clinical context and payer landscape needed to interpret and apply HCPCS Level II code C7558 in national billing and coverage discussions.
Billing Code Overview
HCPCS Level II code C7558 describes a comprehensive diagnostic cardiac catheterization procedure that includes catheter placement in the coronary artery(ies) for coronary angiography, intraprocedural injections for coronary angiography, imaging supervision and interpretation, right and left heart catheterization with intraprocedural injections for left ventriculography when performed, and catheter placement(s) in bypass graft(s) with bypass graft angiography. The service also includes administration of pharmacologic agents (for example, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agents) and assessment of hemodynamic measurements before, during, after, and with repeat pharmacologic administration when performed.
Service type: Diagnostic cardiac catheterization with coronary and bypass graft angiography, hemodynamic assessment, and pharmacologic agent administration.
Typical site of service: Hospital-based cardiac catheterization laboratory or outpatient/inpatient interventional cardiology suite.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of multivessel coronary artery disease, prior coronary artery bypass grafting (CABG) with left internal mammary artery graft to the left anterior descending artery, and progressive exertional angina is referred for invasive coronary angiography. The patient presents to the cardiac catheterization laboratory after outpatient evaluation for worsening chest pain and an abnormal stress test. The clinical workflow includes pre-procedure evaluation and informed consent, vascular access (typically femoral or radial), diagnostic catheter placement in the native coronary arteries and bypass graft(s) for selective injections, intraprocedural pharmacologic challenge or hemodynamic assessment (for example, administration of intravenous nitroprusside or dobutamine) when indicated, right and left heart catheterization with measurement of intracardiac pressures, left ventriculography if indicated, imaging supervision and interpretation, and post-procedure monitoring and recovery. The procedure may be performed in an inpatient or outpatient hospital setting, an ambulatory surgical center, or a dedicated cardiac catheterization laboratory depending on clinical status and facility capabilities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or complexity substantially exceeds typical requirements (document specific reasons). |