Coding and Billing Coronary Sinus Catheters
By: Christine M. Locay, JD, RHIA, CPC
Vice President, Corporate Compliance Counsel

February 4, 2011

Recently, I have received several questions about the correct code for placement of a coronary sinus catheter.  The CPT Assistant addressed this issue in the following April 2009 article (Volume 19, Issue 4, pages 8-10):

Question: What is the correct coding for placement of a coronary sinus catheter? The documentation is as follows: 11 Frx10cm introducer sheath inserted into right internal jugular vein using sterile, modified, Seldinger technique after 1 attempt. Central venous pressure verified. Side-port flushes and aspirates easily. Sheath sutured in place. Coronary sinus catheter placed via sheath and positioned using TEE guidance. Ventricularized waveform obtained at 36 cm using 2 cc saline in balloon. Sterile dressing applied. No hematoma noted.

Answer: In general, coronary sinus catheters are used for research purposes, for left ventricular pacing, in which case the biventricular pacemaker and associated pacing catheter codes are appropriate, or for retrograde perfusion during open heart surgery. Unless the coronary sinus catheter is used for pacing, CPT code 93799, Unlisted cardiovascular service or procedure, is the appropriate code to report. When reporting an unlisted code to describe a procedure or service, it will be necessary to submit supporting documentation (eg, procedure report) along with the claim to provide an adequate description of the nature, extent, and need for the procedure and the time, effort, and equipment necessary to provide the service. (emphasis provided)

Currently, guidance is separately reimbursable.  Fluoroscopic guidance is reported with code 77001.  TEE guidance is also separately reimbursable; however, the TEE is not separately reimbursable if it is primarily for monitoring purposes.

The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.