93563 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separately in addition to code for primary procedure)

Name of the Procedure:

Injection procedure during cardiac catheterization, including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization.

Summary

This procedure involves injecting a contrast dye into specific coronary arteries during a cardiac catheterization to obtain detailed images of the heart's blood vessels. It includes supervision, interpretation, and reporting of the imaging results.

Purpose

The purpose of this procedure is to diagnose congenital heart conditions by obtaining clear images of the coronary arteries. This can help in identifying blockages, abnormalities, or other issues within the heart's blood vessels.

Indications

• Symptoms suggestive of coronary artery disease or congenital heart defects
• Unexplained chest pain or discomfort
• Abnormal cardiac test results (e.g., EKG, stress test)
• Congenital heart disease diagnosed by other means (e.g., ultrasound, MRI)

Preparation

• Patients may need to fast for 6-8 hours before the procedure.
• Medication adjustments may be necessary, especially with blood thinners.
• Pre-procedure blood tests and imaging studies to assess overall health and specific heart problems.

Procedure Description

1. The patient is given local anesthesia or mild sedation.
2. A catheter is inserted into a blood vessel, usually in the groin or arm.
3. The catheter is guided to the heart using X-ray imaging.
4. Once in place, a contrast dye is injected through the catheter into the coronary arteries.
5. High-resolution images are taken to visualize the coronary vasculature.
6. The images are interpreted, and a detailed report is generated by the supervising cardiologist.

Duration

The entire procedure typically takes between 30 minutes to an hour.

Setting

This procedure is usually performed in a hospital's cardiac catheterization lab.

Personnel

• Interventional Cardiologist
• Cardiac Catheterization Technologist
• Nurse
• Anesthesiologist or Sedation Nurse

Risks and Complications

• Common: Bleeding or bruising at the catheter insertion site, allergic reaction to the contrast dye
• Rare: Infection, blood vessel damage, heart attack, arrhythmias

Benefits

• Accurate diagnosis of coronary artery and congenital heart conditions
• Allows for precise treatment planning
• Immediate visualization of any heart blockages or abnormalities

Recovery

• Patients are monitored for a few hours post-procedure.
• Instructions include keeping the insertion site clean and dry, avoiding heavy lifting, and following prescribed medications.
• Most patients can resume normal activities within a day or two.

Alternatives

• Non-invasive imaging tests (e.g., CT angiography, MRI)
• Stress tests
• Echocardiography
• Each alternative has its own pros and cons regarding accuracy, invasiveness, and detail of information provided.

Patient Experience

During the procedure, patients might feel mild discomfort or pressure at the catheter insertion site. Post-procedure, they may experience some bruising or soreness at the insertion site. Pain is usually manageable with over-the-counter medications.