Catheter placement in right heart for congenital anomalies, including intraprocedural injection(s) for right ventriculography, when performed; imaging supervision and interpretation

CPT 93460 is the billing code for "Catheter placement in right heart for congenital anomalies, including intraprocedural injection(s) for right ventriculography, when performed; imaging supervision and interpretation". For right heart catheterization for congenital cardiac anomalies

Medicare pays approximately $1150.24 for CPT 93460 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 93460 has a total RVU of 21.85, broken down as: Work RVU 8.50, Practice Expense RVU 12.50, and Malpractice RVU 0.85. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 93460 include: Indication for cardiac catheterization; Congenital anomaly findings; Right heart pressures and saturations; Right ventriculography findings. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 93460: Includes right heart catheterization. Includes right ventriculography Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 93460 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 93460 is 40-70 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.