Accurate coding depends on which elements your physician performed.Review the 2012 Echocardiography guidelines that precede 93303-+93352, and you’ll find new wording that clarifies coding for a stress test with a stress echo.Complete: When a single physician performs a stress echo and a complete cardiovascular stress test, report 93351 (Echocardiography, transthoracic, real-time with image documentation [2D], includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with [...]
ICD-10-CM: V72.81 Has Almost Perfect Match in Z01.810 (December 2011)
New codes won’t free you from needing to track payer preferences.When ICD-10-CM replaces ICD-9-CM on Oct. 1, 2013, you may find that even those codes that correspond directly to one another have slightly different definitions. As an example, take a look at the codes for preoperative cardiovascular exams.ICD-9-CM: V72.81, Preoperative cardiovascular examICD-10-CM: Z01.810, Encounter for preprocedural cardiovascular examinationThe codes above apply when a patient has an exam related to the cardiovascular system (such as SPECT, [...]
Observation Care: 99224-99226 Are Intended for Treating Physician’s Claims (December 2011)
Look to outpatient E/M codes if you don’t meet this requirement.In effect for about a year now, CPT®’s subsequent observation care codes have been something of a mystery since they were released, but CMS finally ended that by issuing clarifications about how to report these codes.Pinpoint Services Included in 99224-99226The codes in focus are 99224-99226 (Subsequent observation care, per day, for the evaluation and management of a patient …).CMS notes that subsequent observation care pay [...]
Medicare: Leave Cardiovascular Disease Prevention Visit to Primary Care Providers (December 2011)
If you have a physician who qualifies, watch for 3 key coverage requirements.On Nov. 8, CMS announced it will cover an annual cardiovascular disease prevention visit for all beneficiaries.“Access to preventive services helps Medicare beneficiaries identify health risk factors and disease early to provide greater opportunities for early treatment,” said CMS administrator Donald Berwick, MD, in a Nov. 8 statement. Snag: Before you get too excited, take note that CMS is restricting the preventive visit [...]
You Be the Coder: Tag the Proper MUGA Scan Code (December 2011)
Question: During MUGA scans, we use an Ultratag kit. How should we report this?Illinois SubscriberAnswer: Code A9560 (Technetium TC-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries) describes the Ultratag kit used in multi-gated acquisition (MUGA) scans. The Ultratag method is in vitro and involves drawing the patient’s blood, transferring it to a bag or vial, and then adding pertechnetate. About 25 minutes later, staff injects the patient with the labeled [...]
Reader Question: +93567 Starts With Repositioning Cath (December 2011)
Question: May we bill +93567 with heart catheterization codes 93451-93461 if there is no separate catheter placed in the aorta? If yes, should we append modifier 59? SuperCoder.com MemberAnswer: CPT® Changes 2011: An Insider’s View offers a procedure description for +93567 (Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography [List separately in addition to code for primary procedure]) that refers to “repositioning” the catheter. It states: “codes 93530-93533 or [...]
Reader Question: 93452 Doesn’t Require Ventriculography (December 2011)
Question: The physician performed an LHC with no left ventriculography. How should I code this?SuperCoder.com MemberAnswer: Code 93452 (Left heart catheterization including intraprocedural injection[s] for left ventriculography, imaging supervision and interpretation, when performed) is appropriate for this case.The code definition indicates that it includes left ventriculography “when performed.” That last phrase tells you that the left ventriculography is not required for the code to be appropriate, but if the physician performs the left ventriculography, you [...]
Reader Question: 93600 and 93610 Reflect Recording and Pacing (December 2011)
Question: When EP codes refer to recording and pacing, what does this mean?New York SubscriberAnswer: Recording means the electrophysiologist (EP) places an electrode in a certain location in the heart and assesses the electrical activity in that area. For instance, you would report 93600 (Bundle of His recording) if the physician placed an electrode at the bundle of His and recorded electrical activity. You would report 93602 (Intra-atrial recording) for intra-atrial recording and 93603 (Right [...]
CPT® 2012: 33227-33229 Revolutionize Pacemaker Battery Change Coding (November 2011)
Celebrate a simpler way to report single electrode repair in a dual-chamber system.Each CPT® update seems to bring a massive overhaul of a different cardiology coding area, and 2012 will be no exception. Starting January 1, you’ll report pacemaker and pacing cardioverter-defibrillator surgical services in an all new way. To help ease the task of mastering these changes, Cardiology Coding Alert will begin with the big picture view of the new codes in this issue, [...]
Crosswalk: 33206 and 71090 No Longer Pair Up for Pacemaker Implant — Here’s Why (November 2011)
See at a glance how 2011 and 2012 coding compare.Coding changes for pacemakers and implantable cardioverter-defibrillators are sure to be the talk of the cardiology water cooler for a long while. “33227-33229 Revolutionize Pacemaker Battery Change Coding” on page 81 offers an overview of the changes, but there’s plenty more to learn. For example, CPT® 2012 includes radiological supervision and interpretation in 33206-33249 and deletes 71090 (Insertion pacemaker, fluoroscopy and radiography, radiological supervision and interpretation).Simplify [...]
