Question

In order to accurately code a cardiac catheterization, what needs to be determined based on a review of the documentation?

Answer 1

To accurately code a cardiac catheterization, a review of the documentation should determine the name of the procedure, completeness of counts, labeling of specimens, and equipment issues.

Step-by-step explanation:

In order to accurately code a cardiac catheterization, the following needs to be determined based on a review of the documentation:

1. The name of the procedure as recorded
2. The completeness of the needle, sponge, and instrument counts (or determine if not applicable)
3. If any specimen is correctly labeled, including with the patient's name
4. Whether there are any issues with equipment that need to be addressed

By reviewing these factors, healthcare professionals can accurately assign the appropriate codes for cardiac catheterization procedures.