Procedure performed: Left-sided heart catheterization, selective coronary angiography, and left ventriculography
Indication: Chest pain and abnormal Cardiolite stress test
RESULTS
Hemodynamics: The left ventricular pressure before the LV-gram was 117/1 with an LVEDP of 4; after the LV-gram it was111/4 with an LVEDP of 10. The aortic pressure on pullback was 111/17.
Left ventriculography: The left ventriculography showed that the left ventricle was of normal size. There were no significant segmental wall motion abnormalities. The overall left ventricular systolic function was normal, with an ejection fraction of better than 60%.
Selective coronary angiography:
A. Right coronary artery: The right coronary artery is a medium- to large-size dominant artery that has about 80% to 90% proximal/mideccentric stenosis. The rest of the artery has only mild surface irregularities.
B. Left main coronary artery: The left main has mild distal narrowing.
C. Left circumflex artery: The left circumflex artery is a medium-size, nondominant artery. It gives rise to a very high first obtuse marginal/intermedius, which is a bifurcation medium-size artery that has only mild surface irregularities. The second obtuse marginal is also a medium-size artery that has about 20% to 25% proximal narrowing. After that second obtuse marginal, the circumflex artery is a small-size artery that has about 20% to 30% narrowing, a small aneurismal segment.
D. Left anterior descending coronary artery: The left anterior descending artery is a medium-size artery that is mildly calcified. It gives rise to a very tiny first diagonal that has mild diffuse atherosclerotic disease. Right at the origin on the second diagonal, the LAD has about 30% narrowing. The rest of the artery is free of significant obstructive disease. The second diagonal is also a small-caliber artery that has no significant obstructive disease.
Conclusion: Severe single-vessel atherosclerotic heart disease
Select the appropriate ICD-10-CM and CPT code(s):

Question

Procedure performed: Left-sided heart catheterization, selective coronary angiography, and left ventriculography
Indication: Chest pain and abnormal Cardiolite stress test
RESULTS
Hemodynamics: The left ventricular pressure before the LV-gram was 117/1 with an LVEDP of 4; after the LV-gram it was111/4 with an LVEDP of 10. The aortic pressure on pullback was 111/17.
Left ventriculography: The left ventriculography showed that the left ventricle was of normal size. There were no significant segmental wall motion abnormalities. The overall left ventricular systolic function was normal, with an ejection fraction of better than 60%.
Selective coronary angiography:
A. Right coronary artery: The right coronary artery is a medium- to large-size dominant artery that has about 80% to 90% proximal/mideccentric stenosis. The rest of the artery has only mild surface irregularities.
B. Left main coronary artery: The left main has mild distal narrowing.
C. Left circumflex artery: The left circumflex artery is a medium-size, nondominant artery. It gives rise to a very high first obtuse marginal/intermedius, which is a bifurcation medium-size artery that has only mild surface irregularities. The second obtuse marginal is also a medium-size artery that has about 20% to 25% proximal narrowing. After that second obtuse marginal, the circumflex artery is a small-size artery that has about 20% to 30% narrowing, a small aneurismal segment.
D. Left anterior descending coronary artery: The left anterior descending artery is a medium-size artery that is mildly calcified. It gives rise to a very tiny first diagonal that has mild diffuse atherosclerotic disease. Right at the origin on the second diagonal, the LAD has about 30% narrowing. The rest of the artery is free of significant obstructive disease. The second diagonal is also a small-caliber artery that has no significant obstructive disease.
Conclusion: Severe single-vessel atherosclerotic heart disease
Select the appropriate ICD-10-CM and CPT code(s):

Quizplus · Accepted Answer

The correct ICD-10-CM code is I25.110 for atherosclerotic heart disease of the native coronary artery with unstable angina, as indicated by the severe single-vessel atherosclerotic heart disease and the patient's symptoms (chest pain and abnormal stress test). The correct CPT code is 93458 for the procedures performed: left-sided heart catheterization, selective coronary angiography, and left ventriculography.

Procedure Performed: Left-Sided Heart Catheterization, Selective Coronary Angiography, and Left