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Official Description

Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (List separately in addition to code for primary procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93569 refers to an injection procedure performed during cardiac catheterization specifically for selective pulmonary arterial angiography on a unilateral basis. This procedure is typically conducted in conjunction with a primary right heart catheterization, which is a diagnostic technique used to assess the heart's function and blood flow. The selective pulmonary arterial angiography is particularly relevant for evaluating patients with congenital heart defects, often seen in pediatric populations, although it can also be applicable to adults with acquired conditions. During this procedure, a diagnostic catheter is initially positioned in the main pulmonary artery, allowing for the administration of contrast media to visualize the pulmonary artery and its branches. The goal is to identify any abnormalities such as valve regurgitation, irregular blood flow, or structural issues within the vessels. The process involves the introduction of a guidewire into a distal segmental branch of the pulmonary artery, facilitating a more targeted and detailed examination. This procedure is crucial for diagnosing and managing various cardiac conditions, ensuring that any potential issues are accurately identified and documented for further treatment planning.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure associated with CPT® Code 93569 is indicated for the following conditions:

  • Pulmonary Arterial Abnormalities - This includes the assessment of any irregularities in the pulmonary arteries, such as stenosis or other structural defects.
  • Congenital Heart Defects - Particularly in pediatric patients, this procedure is performed to evaluate congenital anomalies affecting the pulmonary circulation.
  • Valve Regurgitation - The procedure helps in assessing the presence of regurgitation at the pulmonary valve, which can impact overall cardiac function.
  • Branching Blood Flow Issues - It is used to investigate any abnormalities in the branching patterns of the pulmonary arteries that may affect blood flow.

2. Procedure

The procedure for CPT® Code 93569 involves several critical steps to ensure accurate selective pulmonary arterial angiography:

  • Step 1: Catheter Positioning - Initially, a diagnostic catheter is positioned in the main pulmonary artery. This positioning is crucial as it serves as the starting point for the angiographic procedure. The catheter is connected to a power injector, which will facilitate the injection of contrast media.
  • Step 2: Contrast Media Injection - Once the catheter is in place, contrast media is injected to opacify the main pulmonary artery. This step is essential for visualizing the artery and assessing for any abnormalities such as valve regurgitation or branching blood flow issues.
  • Step 3: Guidewire Introduction - A guidewire is then introduced through the diagnostic catheter into a distal segmental branch of the pulmonary artery. This allows for selective catheterization, targeting specific areas of interest within the pulmonary circulation.
  • Step 4: Manual or Power Injector Contrast Injection - After the guidewire is positioned, it may be removed, and a manual contrast injection can be performed. Alternatively, the catheter can be exchanged for an angiographic catheter connected to a power injector. This ensures that the contrast is injected accurately after verifying the catheter's position.
  • Step 5: Repeat Injection if Necessary - If there are suspected defects, such as pulmonary branch stenosis following a previous repair (e.g., Tetralogy of Fallot), the injection may be repeated from another angle to obtain additional views for thorough evaluation.
  • Step 6: Image Processing and Interpretation - The resulting angiograms are processed and reviewed by the physician. A written interpretation of the findings is then provided, which is critical for further clinical decision-making.

3. Post-Procedure

After the completion of the selective pulmonary arterial angiography, the patient undergoes monitoring for any potential complications. This includes observing the patient's arterial pressure, heart rhythm, and oxygen levels during the procedure. Post-procedure care involves monitoring for allergic reactions to the contrast media, arrhythmias, kidney damage, or other complications that may arise. The healthcare team ensures that the patient is stable before discharge and provides necessary follow-up instructions based on the findings from the angiography.

Short Descr NJX CTH SLCT P-ART ANGRP UNI
Medium Descr NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI
Long Descr Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary arterial angiography, unilateral (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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) none
MUE 1

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
93505 MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code Endomyocardial biopsy
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.
CR Catastrophe/disaster related
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2023-01-01 Added Code added.
Code
Description
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