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The CPT® Code 93463 refers to the administration of a pharmacologic agent during a heart catheterization procedure, which is a critical intervention used to assess and treat various cardiovascular conditions. This code specifically encompasses the administration of agents such as inhaled nitric oxide, intravenous nitroprusside, dobutamine, milrinone, or other similar medications. The procedure involves a comprehensive evaluation of hemodynamic measurements, which are essential for understanding the patient's cardiovascular status. Prior to the administration of the pharmacologic agent, baseline hemodynamic measurements are obtained to establish a reference point. These measurements may include various parameters such as cardiac index, cardiac output, central venous pressure, mean arterial pressure, preload, afterload, pulmonary artery pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance, right ventricular pressure, stroke index, stroke volume, and systemic vascular resistance. Following the administration of the pharmacologic agent, additional hemodynamic measurements are taken to assess the patient's response to the treatment. This process may involve administering an additional dose of the same or a different pharmacologic agent, with subsequent hemodynamic assessments performed to compare and interpret the results. The physician is responsible for analyzing these measurements and providing a written report detailing the findings. It is important to note that this code is reported separately in addition to the primary procedure of heart catheterization and may only be billed once per session.
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The CPT® Code 93463 is indicated for use in specific clinical scenarios where the administration of a pharmacologic agent is necessary to evaluate hemodynamic responses during a heart catheterization procedure. The following conditions may warrant the use of this code:
The procedure associated with CPT® Code 93463 involves several critical steps to ensure accurate assessment and administration of pharmacologic agents. The following procedural steps are outlined:
After the completion of the pharmacologic agent administration and associated hemodynamic measurements, the patient may require monitoring to assess recovery and response to the treatment. The physician will review the findings from the hemodynamic assessments and determine any necessary follow-up actions or adjustments to the treatment plan. It is essential to document all findings accurately, as this information is critical for ongoing patient management and may influence future therapeutic decisions. The code 93463 may only be reported once in conjunction with the primary heart catheterization procedure, ensuring that all relevant data is captured for billing and compliance purposes.
| Short Descr | DRUG ADMIN & HEMODYNMIC MEAS | Medium Descr | MEDICATION ADMIN & HEMODYNAMIC MEASURMENT | Long Descr | Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent) including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed (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) | 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.
| 33477 | MPFS Status: Active Code APC C Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed | 93451 | MPFS Status: Active Code APC J1 ASC G2 Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed | 93452 | MPFS Status: Active Code APC J1 ASC G2 Left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, 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 | 93458 | 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 left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed | 93459 | 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 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 | 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 | 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. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | GC | This service has been performed in part by a resident under the direction of a teaching physician | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | LC | Left circumflex coronary artery | LD | Left anterior descending coronary artery | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RC | Right coronary artery | RT | Right side (used to identify procedures performed on the right side of the body) | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2017-01-01 | Changed | Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category. |
| 2013-10-14 | Changed | Guideline information changed. Deleted codes 93563 & 93564 and Added Codes 93563 & 93564 to 93530, 93531, 93532, 93533 Effective 2013-10-14 per AMA 2014 corrections document posted 2014-03-24 |
| 2013-01-01 | Changed | Guideline information changed. |
| 2011-01-01 | Added | Added |
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