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The CPT® Code 93574 refers to an injection procedure performed during cardiac catheterization, specifically for selective pulmonary venous angiography of each distinct pulmonary vein. This procedure is typically conducted in conjunction with a primary left heart catheterization, which is a separate reportable procedure. The primary aim of this angiography is to visualize the pulmonary veins, which are the blood vessels that carry oxygenated blood from the lungs to the heart. In a standard case, there are four pulmonary veins; however, anatomical variations may result in patients having one additional vein or one less. The procedure is particularly relevant for pediatric patients, such as infants and children, who may present with congenital cardiac anomalies and pulmonary hypertension, especially following surgical interventions. During the procedure, a catheter is strategically positioned in the pulmonary venous atrium, allowing for targeted imaging of the pulmonary veins. The process involves selectively accessing each vein suspected of having abnormalities or stenosis, which is a narrowing of the blood vessel. The injection of contrast material into the veins enables the physician to assess for any irregularities. The procedure is meticulously monitored, with the patient's vital signs, including arterial pressure, heart rhythm, and oxygen saturation, being continuously observed to ensure safety and to identify any potential complications, such as allergic reactions or arrhythmias. The physician also provides a comprehensive report detailing the findings from the angiography, which is crucial for further clinical decision-making.
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The procedure described by CPT® Code 93574 is indicated for the following conditions:
The procedure for selective pulmonary venous angiography as described by CPT® Code 93574 involves several critical steps:
After the completion of the selective pulmonary venous angiography, the patient is closely monitored for any potential complications. This includes observing for allergic reactions to the contrast material, arrhythmias, kidney damage, or other adverse effects that may arise from the procedure. Continuous monitoring of the patient's arterial pressure, heart rhythm, and oxygen levels is essential during this recovery phase. The physician will also provide instructions for any necessary follow-up care and further evaluations based on the findings from the angiography.
| Short Descr | NJX CATH SLCT PULM VN ANGRPH | Medium Descr | NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY | Long Descr | Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (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 | 4 |
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. | 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). | 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) |
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| 2023-01-01 | Added | Code added. |
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