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The CPT® Code 93568 refers to an injection procedure performed during cardiac catheterization specifically for nonselective pulmonary arterial angiography. This procedure is typically conducted in conjunction with a primary right heart catheterization, which can be necessary for diagnosing various congenital or acquired heart conditions in both adults and children. The primary aim of this procedure is to visualize the main pulmonary artery by injecting contrast media, allowing for a detailed assessment of the artery's structure and function. This includes evaluating for potential issues such as valve regurgitation, abnormal branching of blood vessels, or other vascular abnormalities. The procedure involves positioning a diagnostic catheter in the main pulmonary artery, which is then connected to a power injector for the administration of contrast media. This process is crucial for obtaining clear images that can help in diagnosing and planning further treatment for patients with heart conditions. It is important to note that while nonselective pulmonary arterial angiography is applicable to a broader patient population, selective pulmonary arterial angiography is more commonly performed in pediatric patients, particularly those with congenital heart defects. The careful monitoring of the patient's vital signs and potential complications during and after the procedure is also a critical aspect of the overall process.
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The injection procedure for nonselective pulmonary arterial angiography (CPT® Code 93568) is indicated for the evaluation of various conditions affecting the pulmonary artery. The following are the explicitly provided indications for this procedure:
The procedure for nonselective pulmonary arterial angiography involves several critical steps, which are detailed as follows:
Following the nonselective pulmonary arterial angiography, patients are typically monitored for any adverse reactions to the contrast media, which may include allergic responses or kidney function impairment. Continuous observation of the patient's heart rhythm and vital signs is essential during the recovery phase. Additionally, any complications such as arrhythmias or other cardiovascular issues must be promptly addressed. The physician will provide a written interpretation of the findings from the angiography, which will guide further management and treatment decisions based on the results obtained during the procedure.
| Short Descr | NJX CAR CTH NSLC P-ART ANGRP | Medium Descr | NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY | Long Descr | Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P2F - Major procedure, cardiovascular-Other | MUE | 1 | CCS Clinical Classification | 47 - Diagnostic cardiac catheterization, coronary arteriography |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 33361 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; percutaneous femoral artery approach | 33362 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open femoral artery approach | 33363 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open axillary artery approach | 33364 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; open iliac artery approach | 33365 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transaortic approach (eg, median sternotomy, mediastinotomy) | 33366 | MPFS Status: Active Code APC C Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; transapical exposure (eg, left thoracotomy) | 33418 | MPFS Status: Active Code APC C Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis | 33419 | Addon Code MPFS Status: Active Code APC N ASC N1 Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; additional prosthesis(es) during same session (List separately in addition to code for primary procedure) | 33477 | MPFS Status: Active Code APC C Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed | 33741 | Modifier 63 Exempt MPFS Status: Active Code APC C Transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (eg, Rashkind, Sang-Park, balloon, cutting balloon, blade) | 33745 | MPFS Status: Active Code APC C Transcatheter intracardiac shunt (TIS) creation by stent placement for congenital cardiac anomalies to establish effective intracardiac flow, including all imaging guidance by the proceduralist, when performed, left and right heart diagnostic cardiac catheterization for congenital cardiac anomalies, and target zone angioplasty, when performed (eg, atrial septum, Fontan fenestration, right ventricular outflow tract, Mustard/Senning/Warden baffles); initial intracardiac shunt | 33894 | MPFS Status: Active Code APC C Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; across major side branches | 33895 | MPFS Status: Active Code APC C Endovascular stent repair of coarctation of the ascending, transverse, or descending thoracic or abdominal aorta, involving stent placement; not crossing major side branches | 33900 | MPFS Status: Active Code APC J1 ASC J8 Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral | 33901 | MPFS Status: Active Code APC J1 ASC J8 Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, bilateral | 33902 | MPFS Status: Active Code APC J1 ASC J8 Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, unilateral | 33903 | MPFS Status: Active Code APC J1 ASC J8 Percutaneous pulmonary artery revascularization by stent placement, initial; abnormal connections, bilateral | 33904 | Add-on Code MPFS Status: Active Code APC N Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure) | 37187 | MPFS Status: Active Code APC J1 ASC J8 Physician Quality Reporting Illustration for Code Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance | 37188 | MPFS Status: Active Code APC J1 ASC J8 Physician Quality Reporting Illustration for Code Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance, repeat treatment on subsequent day during course of thrombolytic therapy | 37236 | MPFS Status: Active Code APC J1 ASC J8 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; initial artery | 37237 | Addon Code MPFS Status: Active Code APC N ASC N1 Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or coronary), open or percutaneous, including radiological supervision and interpretation and including all angioplasty within the same vessel, when performed; each additional artery (List separately in addition to code for primary procedure) | 37238 | MPFS Status: Active Code APC J1 ASC J8 Transcatheter placement of an intravascular stent(s), open or percutaneous, including radiological supervision and interpretation and including angioplasty within the same vessel, when performed; initial vein | 37246 | CPT Resequenced MPFS Status: Active Code APC J1 ASC J8 Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same artery; initial artery | 37248 | CPT Resequenced MPFS Status: Active Code APC J1 ASC J8 Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein | 92997 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel | 92998 | Addon Code MPFS Status: Active Code APC N CPT Assistant Article Illustration for Code Percutaneous transluminal pulmonary artery balloon angioplasty; each additional vessel (List separately in addition to code for primary procedure) | 93451 | MPFS Status: Active Code APC J1 ASC G2 Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed | 93453 | MPFS Status: Active Code APC J1 ASC G2 Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed | 93456 | MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right heart catheterization | 93457 | MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization | 93460 | MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed | 93461 | MPFS Status: Active Code APC J1 ASC G2 Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography | 93580 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Percutaneous transcatheter closure of congenital interatrial communication (ie, Fontan fenestration, atrial septal defect) with implant | 93581 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Percutaneous transcatheter closure of a congenital ventricular septal defect with implant | 93582 | MPFS Status: Active Code APC J1 Percutaneous transcatheter closure of patent ductus arteriosus | 93583 | MPFS Status: Active Code APC C Percutaneous transcatheter septal reduction therapy (eg, alcohol septal ablation) including temporary pacemaker insertion when performed | 93593 | MPFS Status: Carrier Priced APC J1 Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; normal native connections | 93594 | MPFS Status: Carrier Priced APC J1 Right heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone; abnormal native connections | 93595 | MPFS Status: Carrier Priced APC J1 Left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone, normal or abnormal native connections | 93596 | MPFS Status: Carrier Priced APC J1 Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); normal native connections | 93597 | MPFS Status: Carrier Priced APC J1 Right and left heart catheterization for congenital heart defect(s) including imaging guidance by the proceduralist to advance the catheter to the target zone(s); abnormal native connections |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | LT | Left side (used to identify procedures performed on the left side of the body) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | RT | Right side (used to identify procedures performed on the right side of the body) | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2023-01-01 | Changed | Code description changed. |
| 2022-01-01 | Changed | First appearance of guideline change in codebook. |
| 2021-06-07 | Changed | First guideline changed per CPT errata to include 33741, 33745. |
| 2021-01-01 | Note | Guidelines changed. |
| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-01-01 | Changed | Guideline information changed. |
| 2011-01-01 | Added | Added |
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