Billing and Coding: Cardiac Catheterization and Coronary Angiography

This policy provides billing and coding rules for cardiac catheterization and coronary angiography: Medicare Part B generally covers the professional component in hospital and outpatient settings and covers both components for office diagnostic caths, subject to required documentation and supervision. Claims must include appropriate ICD-10 codes linked to CPT codes, required artery modifiers for specific CPTs, and numerous bundling rules — many component services and certain codes (e.g., G0269 physician billing, 93598) are not separately reimbursable. Routine inpatient/observation stays after outpatient catheterization will be denied unless complications occur, and specific frequency rules apply (e.g., many CPTs bill only once per catheterization; 93505 billed as one unit).

"Medicare Part B covers the professional component of cardiac catheterization and coronary angiography when performed in hospital inpatient and outpatient facility settings."