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Reader Question: Report Transseptal Puncture With 93528

Question: What is a "transseptal puncture" procedure, and how should I report it?

Kentucky Subscriber

Answer: "Transseptal puncture" refers to a type of heart catheterization. The physician begins this procedure with a right heart catheterization through the femoral, subclavian, internal jugular, or antecubital vein to the right atrium. She then passes the catheter through the tricuspid valve into the right ventricle and into the pulmonary arteries.

This procedure stands out from other kinds of right and left heart catheterizations because the left heart portion of the procedure requires the physician to puncture the atrial septum to get the catheter into the left ventricle. You should report this service with code 93528 (Combined right heart catheterization with left ventricular puncture [with or without retrograde left heart catheterization]).