Thanks to a new proposal from the Centers for Medicare and Medicaid Services (CMS), cardiac catheterization might be coming to a whole new type of facility. According to the 2019 Outpatient Prospective Payment System (OPPS), CMS is proposing that ambulatory surgery centers (ASCs) be able to perform 12 different procedures involving this type of catheterization. A brief paraphrase of each code is provided below:
- 93451: “Right heart catheterization”
- 93452: “Left heart catheterization”
- 93453: “Combined right and left heart catheterization”
- 93454: “Catheter placement in coronary artery(s) for coronary angiography”
- 93455: “with catheter placement(s) in bypass graft(s) for bypass graft angiography”
- 93456: “with right heart catheterization”
- 93457: “with catheter placement(s) in bypass graft(s) including intraprocedural injection(s) for bypass graft angiography and right heart catheterization”
- 93458: “with left heart catheterization”
- 93459: “with left heart catheterization, bypass graft angiography”
- 93460: “with right and left heart catheterization including intraprocedural injection(s)”
- 93461: with right and left heart catheterization including bypass graft angiography”
- 93462: “Left heart catheterization by transseptal puncture”
Unfortunately, this is not the good news that it may seem at first glance. CMS made no mention of approving ASCs to perform procedures with cardiac interventions, meaning that patients will still need to present to hospitals if they need stents. This will almost certainly have to occur on a different day, which will likely prove troublesome for many patients, as stenting usually occurs immediately after the decision is made to perform it. Furthermore, this split across multiple facilities will require patients to schedule and pay for two separate appointments.
If you code for an ASC, keep in mind that these procedures may soon be approved for your workplace, so stay tuned for more updates regarding cardiac catheterization and its implementation within new facilities. In the meantime, be sure to review the codes listed above, as there may soon be a sharp influx of ASC catheter patients.