Vascular Update: 36251-36254 Make Old Renal Codes Obsolete   (November 2011)

Ring in the New Year with updates for IVC filters, too.The trend toward more all-in-one codes isn’t slowing under CPT® 2012. Renal angiography and IVC filter procedures will see new codes that combine surgical and imaging services into one neat package. Replace Your Old Renal Angiography CodesRenal angiography sports four new codes effective Jan. 1, 2012. Key elements distinguishing the codes include whether the service is first order or higher and whether the service is [...]

E/M Update: 99218-99220 Add Typical Times for 2012   (November 2011)

Rumor has it the revisions could add options for reporting these observation codes.Have you ever wished that CPT® would put a time guide on its observation codes? Then you’ll be in luck as of Jan. 1, 2012, when the new manual will offer specific typical times that relate to each of the initial observation care codes. Observation Time Guidelines Could Open DoorsWhen CPT® 2011 debuted 99224-99226 (Subsequent observation care, per day, for the evaluation and [...]

You Be the Coder: 37221 and 37226 Join Forces?   (November 2011)

Question: How should I code external iliac and common femoral angioplasty stent procedures? Would it be only 37221? Or may I also code 37226?SuperCoder.com MemberAnswer: If the physician performed separate therapies for the iliac and femoral arteries, you should report both 37221 (Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, initial vessel; with transluminal stent placement[s], includes angioplasty within the same vessel, when performed) and 37226 (Revascularization, endovascular, open or percutaneous, femoral, popliteal artery[s], unilateral; [...]

ICD-10-CM: 404.0x Differs From I13.- in Use of Malignant and Benign   (November 2011)

ICD-10-CM narrows your code options from 12 to 4 for hypertensive heart and CKD.You can expect ICD-10-CM to provide you with combination codes for certain chronic conditions just as ICD-9-CM does, but that doesn’t mean the code definitions will be precisely the same.To see a practical example, review the codes below, which you assign when a patient has both hypertensive heart disease (documentation indicates hypertension causes heart disease) and hypertensive chronic kidney disease (hypertension with [...]

Reader Question: 93454’s Global Period Affects Discharge   (November 2011)

Question: May I report 99238, discharge from hospital, on the same date as coronary angiogram? Medicare says discharge is covered in the surgery’s global days, but coronary angiography has 0 global days.SuperCoder.com MemberAnswer: A 0-day global period means that Medicare will bundle all E/M services on the surgery date into the surgical code.As a result 99238 (Hospital discharge day management; 30 minutes or less) is bundled into 93454 (Catheter placement in coronary artery[s] for coronary [...]

Reader Question: G0389 Counterpart Depends on Documentation   (November 2011)

Question: We use G0389 for AAA screening of Medicare patients. What is the corresponding CPT® code for commercial payers?SuperCoder.com MemberAnswer: CPT® doesn’t provide a precise match for G0389 (Ultrasound B-scan and/or real time with image documentation; for abdominal aortic aneurysm [AAA] screening), but your most likely options are 76700-76705 (Ultrasound, abdominal, real time with image documentation …) and 76770-76775 (Ultrasound, retroperitoneal [e.g., renal, aorta, nodes], real time with image documentation …).CPT® guidelines state that retroperitoneal ultrasound [...]

Reader Question: 92975 Is Included in 92980   (November 2011)

Question: May I report 92975 for TPA with stent code 92980, or is the TPA included? I see that a modifier is allowed, but under what circumstance would this be correct coding? SuperCoder.com MemberAnswer: The Correct Coding Initiative (CCI) edit that bundles 92975 (Thrombolysis, coronary; by intracoronary infusion, including selective coronary angiography) into 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) tells you not to [...]

ICD-9 2012: 414.4 Lets You Get Specific About Calcified Coronary Lesions   (October 2011)

But 425.1 will bring instant denials as of October 1.Don’t consider your ICD-9 2012 update lists final until you’ve studies these late additions for coronary atherosclerosis and hypertrophic cardiomyopathy. Although coders get a sneak peek at ICD-9 changes each summer in CMS’s proposed Inpatient PPS rule, those changes aren’t the last word for updates. The codes below weren’t finalized in time to be included in the proposed rule, but they are effective Oct. 1, 2011, [...]

Diagnosis Coding: 6 Techniques to Add to Your ICD-9 Toolbox   (October 2011)

Cheat sheets come with a warning label.To help ensure your coding complies with ICD-9 guidelines, there are several tactics you can use:1. Always read the notes in the ICD-9 manual that apply to the code you’re considering, says Denae M. Merrill, CPC, HCC coding specialist in Michigan. 2. Read the ICD-9 official guidelines that apply to your “specialty periodically as a refresher. If we only read them when the codes change once a year, it [...]

CCI Update: 36000 and More Benefit From Edit Deletions in October   (October 2011)

Plus: 93602 and 93610 are no longer bundled with 92961. In the latest version of the Correct Coding Initiative (CCI), it’s the deleted edit pairs – rather than the added ones – that may be of most interest to you. Check out these vascular and electrophysiology (EP) changes, effective Oct. 1, 2011, for physicians. Don’t Assume Old 36xxx Edits Still Apply This version of CCI deletes 835 edit pairs, notes Frank Cohen, principal and senior analyst for [...]