Cardiac Catheterization and Coronary Angiography

Cardiac catheterization and coronary angiography are covered when medically necessary for specific diagnostic or treatment-planning indications including right- and left-sided valvular disease, heart failure, congenital heart disease, pulmonary vascular disease, myocardial ischemia/infarction, suspected graft/stent closure, and selected preoperative evaluations. Many elements (e.g., vascular closure devices, catheter repositioning, dye injections for catheter guidance, and certain intra-procedure monitoring) are bundled into the catheterization codes and are not separately reimbursable; extra-cardiac angiography and additional procedures performed during the same session require independent documentation of medical necessity and a specific request. Documentation requirements include a formal procedure report, pre/intra/post measurements for pharmacologic or exercise hemodynamic testing, recorded reasons for delayed interventions, and attestation of ACC/AHA Level 2 training and required teaching-physician presence when applicable.