One catheter across two phases

Read an original fictional chart, identify the supported facts, and explain your coding workflow.

Chart gym · Original fictional record

Service date: 2026-09-09 · Medicare respiratory or cardiovascular professional service

Use your code books and write your reasoning before opening the walkthrough. This exercise contains no real patient information.

Procedure context

A fictional adult undergoes non-coronary diagnostic and interventional work in a documented vessel. The report identifies the access route, selective catheter position and the work performed. This exercise concerns placement units; the exact intervention and diagnostic-study conditions require separate review.

Catheter timeline

The physician places the catheter in the target vessel for the diagnostic phase. It remains in place while the team prepares for the intervention, then is used for treatment. The record does not document withdrawal followed by another separately performed placement.

Imaging purpose

Contrast injections during treatment are used to position equipment and guide the procedure. The record does not label those positioning injections as a new medically necessary diagnostic study. The prior diagnostic information remains available.

Proposed charge

A draft counts two selective placements because the note has diagnostic and treatment phases. Another adds an angiogram for each positioning injection. The learner must distinguish actual placement and diagnostic work from phases of one intervention.

Your coding worksheet

Count actual documented placements.
Explain the effect of leaving the catheter in place.
Separate diagnostic work from positioning injections.
List the remaining full-entry and angiography-condition checks.

In your notebook, record the supported facts, your index route, the instructions you checked, and any missing detail that limits your answer.

Compare with the worked explanation

Only one selective placement is documented in this relationship.
An interval between phases does not create a second placement when the catheter remains in place.
Positioning injections are not automatically another diagnostic angiogram.
Use the complete current entries and NCCI conditions for any diagnostic study and intervention; do not infer services from report headings.

Reference sections: D.12–13

Practice the linked chart questions