Cardiology Coding Alert

CPT 2011:
37220 to +37223 Revamp Your Iliac Intervention Coding Options
Think outside the box for iliac atherectomy. Are you ready to apply CPT's new revascula... Read more
2011 Fee Schedule:
Will CMS Slash 2011 Conversion Factor by Over 30 Percent Versus Current Rates?
Plus: Cardiology RVUs could see 2 percent drop.Another season of nail-biting has passed, w... Read more
Clip and Save:
37220-+37223 Choices Become Clear With This Tool
Follow the path to make the switch to 2011 codes a snap.Make the transition to new iliac r... Read more
Compliance:
Practices Collected Over $8 Million in Part B Pay for DOS After Patients Died
Don't let date format confusion lead to refund requests.Part B practices should always be ... Read more
Reader Questions:
396.2 Solves Stenosis + Regurgitation Question
Question: Which codes should I report for aortic valve stenosis and mitral valve regurgita... Read more
Reader Questions:
G0436-G0437 Join Smoking Cessation Options
Question: I heard we're supposed to use G codes instead of CPT codes for tobacco cessation... Read more
Reader Questions:
90656 and 90658 Represent Flu Vaccine Supply
Question: Should we use a HCPCS code for basic flu vaccine supply?Answer: Assuming you're ... Read more
You Be the Coder:
99211 on Coumadin Day?
Question: When we report a finger-stick Coumadin test, may we also report a low-level E/M,... Read more
CPT 2011:
93563-93568 Shake Up Your Cardiac Cath Injection Coding Options in 2011
Don't miss the 'congenital' focus of 93563-93564. The countdown to 2011 ha... Read more
CPT 2011:
93922-93924 Go for the 'Longest Code Definition' Prize
Don't miss the changes to the number of levels required.If you've been longing for more de... Read more
CPT 2011:
99224-99226: See Subsequent Observation Care Codes for Yourself
Soon you'll have initial, subsequent, and discharge options.Last month's issue of Cardiolo... Read more
Invasive Cardiology:
75710: Check Heart Cath Documentation Before You Add This Code
Payer preference and anatomic side may change your coding.You typically need more than one... Read more
CCI Update:
83704 Takes Column 1 Spot in Lab Edits
Don't try to report this code with lipid panel.If your practice performs its own lab tests... Read more
Reader Questions:
Modifier 63 Doesn't Belong on Imaging Claims
Question: If we perform an imaging service for an infant, should we append modifier 63?Ind... Read more
Reader Questions:
99212 May Apply to Med Check
Question: The physician started an established patient on a new drug. Two weeks later, the... Read more
Reader Questions:
93641 Applies for ICD Test at Implant
Question: For an EP test of an internal cardioverter-defibrillator (ICD) at implant, shoul... Read more
Reader Questions:
Catch Up on Incomplete Claims
Question: Our practice has a few claims that have missing or incorrect information. I'm no... Read more
You Be the Coder:
+37250 and +92978 Differ on S&I Rule
Question: Does IVUS include S&I for the IVUS, or can you report both?Wisconsin Su... Read more
Correct Coding Initiative:
93025 Rule in CCI Manual Finally Gets an Update
Plus: See what's new for cardiac rehab.Conflicting guidelines rank near the top of the "fr... Read more
Correct Coding Initiative:
35475 and 35476 Switch Columns in October CCI Release
Following old rules could cost you $550 per procedure.This has been a year of changes for ... Read more
CPT 2011 Update -- 93451-93464 Will Bulk Up Your Cardiac Cath Coding Options in the New Year
Don't forget to check revisions -- CPT's still tinkering with wearable ECG recording.... Read more
E/M:
MDM Level May Depend on Proper Table of Risk Selection
Acute cardiac conditions should have you considering high risk level.You could be losing E... Read more
Reader Questions:
Q9967 Pay Goes to Entity Bearing Cost
Question: I saw a list of top reported codes for cardiology. Number two was Q9967. Should ... Read more
Reader Questions:
93650-93652 Apply Regardless of Method
Question: What is the appropriate code for cardiac ablation when performed using radiofreq... Read more
You Be the Coder:
93501, 93510, or 93526 for Right and Left Cath ?
Question: Which codes should I assign for right and left cardiac catheterization with nati... Read more
Interventional Coding:
Part 2: Master the Skills Required for Multiple Coronary Stents
Get expert tips on which modifiers to use for vessels beyond the big 3.When you know the C... Read more
Stent Coding:
Let Add-On Codes Add to Your 92980 Bottom Line
Identify the vessels involved before you make your coding decision.CPT's parenthetical not... Read more
News You Can Use:
Catch These Important MRA and Tobacco Cessation Announcements
See whether tobacco-related illnesses are still a 99406 must.Coverage changes are in the w... Read more
ICD-9 Update:
Cocaine Poisoning? Add 970.81 to Your Coding Options
Try your hand at this critical care scenario.When the emergency department calls your card... Read more
Reader Questions:
Heed 93270's Minimum Transmission Requirement
Question: May we report 93270 even when the only transmission was the test transmission?Il... Read more
Reader Questions:
Let Diaphragm Guide Aneurysm Coding
Question: What distinguishes a thoracic aortic aneurysm from an abdominal aortic aneurysm?... Read more
Reader Questions:
Bundle Follow-Up Into 33206-33208
Question: When a patient returns for suture removal following pacemaker insertion, can we ... Read more
Reader Questions:
Count All Relevant Time on Discharge Day
Question: The cardiologist admitted a patient and then discharged the patient five days la... Read more
Reader Questions:
Don't Overdo 93556 Reporting
Question: For LHC with a left ventriculography and angiography of the LCX, LAD, and RCA, s... Read more
You Be the Coder:
Knock Out 'Normal ECG' Question
Question: A patient presents with complaints of periodic fainting spells and perception of... Read more
Interventional Coding:
Part 1: Sidestep These Top Stent Coding Pitfalls
Have you mastered when to report a diagnostic cath?Coding for coronary stents can be a min... Read more
Don't Forget to Designate Professional Component
In the stent coding example on p. 58, codes 93510, 93555, and 93556 all have both professi... Read more
Nuclear Medicine:
Take This Quick MUGA Coding Challenge
Watch for this variation to the Ultratag kit.Set aside a little time to confirm your MUGA ... Read more
Echocardiography:
Master Coding for Multiple TEEs
Proceed with caution when you're tempted to report 93314 twice. CMS's Medicall... Read more
Fee Schedule:
Make the Most of 2.2 Percent Increase to Medicare Rates
Questions remain about whether the reimbursement yo-yo will start again in the fall.If you... Read more
Reader Questions:
Add a Diagnosis to Explain Pre-Op ECG
Question:We've been getting denials for our pre-op exam ECGs. What is the correct ICD-9 co... Read more
Reader Questions:
Pair Pronto Device to Proper Code
Question:The cardiologist documented a \"Pronto\" thrombectomy. Which code is appropriate ... Read more
Reader Question:
CMS Spells Out MD's Role in E/M
Question:I've heard that for an E/M visit, the physician is responsible for certain parts ... Read more
Reader Questions:
Count on Combo Code for Heart/Kidney Disease
Question:If documentation shows hypertensive heart disease and hypertensive kidney disease... Read more
Reader Questions:
427.81 List Simplifies Sick Sinus Coding
Question:Which codes should I report when the cardiologist inserts a dual-chamber pacemake... Read more
Reader Questions:
Check ICD-9 Guide for 425.8 Clues
Question:I wanted to look up the ICD-9 codes for sarcoidosis with cardiomyopathy in my ICD... Read more
You Be the Coder:
Ace This Aortogram Report
Question: How should I code a report for an infrarenal abdominal aortogram? The report not... Read more
CCI Update:
Get the Scoop on What's In and What's Out for Cardiology Edit Pairs
Beware of coding transcatheter therapy and vascular imaging on the same date.Correct Codin... Read more
Echocardiography:
Tackle Proper TEE Coding for Cleaner Claims
Think you don't need modifier 26 for 93314? Think again. Transesophageal echocardi... Read more
E/M Coding:
Capture Additional 99215 Opportunities By Mastering Time-Based Coding
Employ this start/stop time tip to stand up to audit scrutiny.The cardiologist provides an... Read more
Reader Questions:
Separate Hypertension Diagnoses
Question: Should I report both essential hypertension and pulmonary hypertension together?... Read more
Reader Questions:
Check CPT and CCI About Conscious Sedation
Question: Is it OK to report conscious sedation for a cardiac catheterization?Florida Subs... Read more
Reader Questions:
Extra Long Visit? Consider +99354
Question: The cardiologist spent 105 minutes evaluating a new patient in the office. Is 99... Read more
Reader Questions:
Bypass Matters for Injection Code
Question: How should I report an injection procedure during a heart catheterization if the... Read more
Reader Questions:
Check Rules for Injection + E/M
Question: A payer denied our claim for an established patient office visit in addition to ... Read more
You Be the Coder:
Pick Proper ICD Codes
Question: How should I code the following services from a single operative note? Incision ... Read more
ICD-9 2011 Preview:
Diagnosis Update: Get Ready for New Ectasia Codes Come Oct. 1
Plus, check out V13.65 for corrected congenital heart malformations.Each October you're fa... Read more
Device Evaluations:
Quickly Locate Remote Device Evaluation Requirements
Knowing the difference between in-person and remote evaluations will make your coding choi... Read more
E/M Primer:
Scope Out Potential Level 4 and 5 E/Ms by Knowing Crucial HPI Facts
Watch out for CPT/Medicare differences when counting HPI elements.If you're not accurately... Read more
Clip and Save:
Capture HPI Elements Using These Questions
Get your cardiologist to capture the information you need with this handy list.When counti... Read more
Reader Questions:
No LV Gram Required for 93526
Question: Which code is appropriate when the cardiologist performs a right heart catheteri... Read more
Reader Questions:
Keep Same HTN Code for Uncontrolled/Controlled
Question: Does ICD-9 distinguish controlled and uncontrolled hypertension (HTN)? Missouri ... Read more
Reader Questions:
Tackle Tilt-Table Coverage Requirements
Question: When I report a comprehensive electrophysiology study and tilt table test on the... Read more
Reader Questions:
Append 57 to Non-Consult Code, Too
Question: "Check Major Vs. Minor for Mod 57," in Cardiology Coding Alert, Vol. 12, No. 13,... Read more
Reader Questions:
Catch These Critical Care Clues
Question: I've experienced some denials on critical care codes for patients I though... Read more
You Be the Coder:
Report 93923 Twice for Bilateral Studies
Question: My cardiologist performed complete multi-level bilateral ankle/brachial indices ... Read more
Nuclear Medicine:
Prevent Nuclear Med Troubles With Just a Few Expert FAQ Answers
If you don't pay attention to "per study dose" designations, you could be setting your pra... Read more
Coumadin Coding:
Thin Out Your Coumadin Pay Concerns With Clear Coding Advice
Hint: Watch the diagnosis -- you may be surprised by what you find.Make sure you're n... Read more
News You Can Use:
Rely on Old Rules for Split/Shared Visits -- Despite Consult Coding Changes
Be aware: You should still report just one inpatient care code per patient, per day.As lon... Read more
Reader Questions:
Look to LCD for Additional ABI Requirements
Question: When can I report ABIs separately and when should I include them in the office v... Read more
Reader Questions:
Skip Coding Without a Face-to-Face Encounter
Question: From his office a cardiologist reviews lab test results and, by telephone, order... Read more
Reader Questions:
Save 99238-99239 for 0-Day Globals
Question: My cardiologist admitted a patient and performed a procedure on the 23rd of the ... Read more
Reader Questions:
Equate CVA 'Insertion' With 'Access'
Question: If documentation refers to a "PICC" line terminating in the subclavian, should I... Read more
Reader Questions:
Discover Disconnect Date's Proper Place
Question: Which date(s) of service should I report for 30-day cardiac event monitoring? ... Read more
You Be the Coder:
Determine Proper PTCA Codes
Question: Which CPT codes describe left anterior descending artery PTCA with stent inserti... Read more
Perform AICD Services? Don't Miss This All New V12.53 Rule
Check your files for claims denied since Oct. 1, 2007, and collect your fees. You can add... Read more
Advance Your Angio Skills With This Carotid Scenario
Knowing right from left can bring a$105 reward. How do you handle a case with a common ca... Read more
Take a Sneak Peek at ICD-10 Codes for AICD Diagnoses
Is your documentation up to the seven-character challenge? If you've got the 2013 transit... Read more
News You Can Use:
Make Up for Lost Time: EP Edit Deletion Is Official
If you've been holding study claims, the time to send them in is here. Correct Coding Ini... Read more
Reader Questions:
Watch Global Period for 33215 Service
Question: If the cardiologist repositions and reconnects a dislodged transvenous, right v... Read more
Reader Questions:
Land On 0126T for IMT Screen
Question: Which CPT code describes carotid IMT screening? Washington Subscriber Answer: ... Read more
Reader Questions:
Avoid Multiplying Bilateral 36245 Claims
Question: One of the coders in our office is reporting two units of 36245-50 for bilatera... Read more
Reader Questions:
Add PFSH to Determine History
Question: The cardiologist performed a comprehensive exam and high complexity medical dec... Read more
You Be the Coder:
Consider Congenital Echo Codes
Question: A pediatrician sent a patient to us because he suspected a congenital heart def... Read more
Fine Tune Your 78452, 78454 Skills to Make the Most of Your MPI Claims
Spot the SPECT service, and bring in an extra $193. January 2010 brought a double whamm... Read more
Dig Into 78452, 78454 Documentation Do's
Although performing wall motion and ejection fraction services won’t change your phy... Read more
Triple Your CMS Cardio Screening Know-How With 3 FAQs
Understanding the asymptomatic/screening link is key for proper reporting.If you don&rsquo... Read more
Tap Into Consult Coding Change Tips From NGS Medicare
At least 1 contractor offers hope when admitting physician forgets AI.If you’re stil... Read more
Reader Question :
MIP = 3D Postprocessing for CTA
Question: Does documenting MIP reconstruction support reporting CTA instead of CT (noncoro... Read more
Reader Question :
Leave G9143 to Testing Entity
Question: When should I use the new testing code for warfarin (G9143)?Wisconsin Subscriber... Read more
Reader Question :
Try 022xT for Acoustic Cardiography
Question: I heard there were new Category III codes for cardiography going into effect in ... Read more
Reader Question :
Find Flush and Runoff in 75630
Question: Can the cardiologist perform flush aortogaphy and abdominal runoff from the same... Read more
Reader Question :
Nervous Patient? Check 796.2
Question: We have a patient who was diagnosed with white coat hypertension. Is there an IC... Read more
You Be the Coder :
Analyze This EP Report
Question: How should I code the following case? The electrophysiologist (EP) performed an ... Read more
93000-93010:
Hone Your ECG Coding Skills With 3 Essential Pointers
Grasping 93010's effect on new vs. established patient status could bring a $58 reward.Whe... Read more
Require More Than 'ECG Normal' for Report
Look to this Medicare manual for documentation guidance.Before you report the professiona... Read more
Delve Deeper Into Medicare's Wrong Body Part NCD
Modifier PA: Catch this mid-surgery game-plan change exception. In a perfect world, you'l... Read more
Choose the 2-Payer Consult Strategy That Works for You
In MSP cases, CMS suggests nonconsult code for both payers. Medicare may have scratched c... Read more
Stop $105 Bovine Arch Blunders in Their Tracks
One size doesn't fit all for catheter coding. Take a gander at the average patient's anato... Read more
Reader Question:
Beware of This Transseptal Puncture Trap
Question: We're having trouble getting 93527 reimbursement. I've heard we should use modi... Read more
Reader Question:
Be Sure AI, Not A1, Lands on Admit Claim
Question: Has Medicare released the modifier that the admitting physician is supposed to ... Read more
Reader Question:
Consider 794.31 Best Bet for QRS Variations
Question: Some of our cardiologists document narrow or wide QRS complex. What do these tr... Read more
Reader Question:
Append 59 to Col. 2 Unless Payer Objects
Question: Different insurance companies tell me different things about where to place mod... Read more
Reader Question:
Watch for Separate Second/Third Order Families
Question: The cardiologist documented catheterization of the right vertebral (third order... Read more
Reader Question:
Check 33208 Global to Prevent E/M Snafu
Question: If the cardiologist performs a pacemaker insertion in the hospital and later vi... Read more
You Be the Coder:
Base Battery Code on Expected vs. Complication
Question: Which ICD-9 code should we use when a pacemaker battery dies? Oklahoma Subscrib... Read more
Red Alert:
Expect EP Study + Ablation Denials Until April 1
CMS won't fix CCI blunder until version 16.1, to be released in the spring. If your heart... Read more
At a Glance:
See EP Claims Hit by Erroneous CCI Edits
Don't expect Medicare payment for bundled studies this winter.... Read more
News Flash:
ACC Is Fighting Mad Over MPFS Cuts
But the court has stopped the society's legal action in its tracks. The American College ... Read more
Part 1:
Bolster Your Modifier PA, PB, and PC Know-How in 3 Steps
Are you guilty of this simple modifier 26 mistake? Deciding to assign a "wrong surgery" m... Read more
Reader Questions:
Search Beyond Descriptor for Proper 71090 Use
Question: I'm trying to find the code for radiological supervision and interpretation of ... Read more
Reader Questions:
Add 93539 for LIMA/RIMA
Question: May I code left internal mammary artery (LIMA) and right internal mammary arter... Read more
Reader Questions:
Focus on Electrode Number in 2010
Question: How do the 2010 changes to electrode repositioning codes affect our coding? Flo... Read more
Reader Questions:
Keep Tabs on DOS Policy Change
Question: Did CMS's date of service rules go into effect on Jan. 4 as planned? Tennessee ... Read more
Reader Questions:
Look to Complication Code for This Thrombosis
Question: For a patient with end stage renal disease, what is the appropriate ICD-9 code ... Read more
Reader Questions:
Count to 1 and Done for 93545
Question: When the cardiologist injects both the left coronary and the right during a ca... Read more
You Be the Coder:
Steer Clear of Dyspnea Pitfall
Question: Should I report paroxysmal nocturnal dyspnea using one of the sleep apnea (327.... Read more
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