Cardiology Coding Alert

CCI Update:

Act Now to Get Hard-Earned 93296 Pay From CMS

Take advantage of edit deletions --3 months of denials add up at $36 a pop.

Correct Coding Initiative 15.1 adds more than 300,000 edits, but the most exciting news for cardiology coders is among the deletions -- which means good news for remote device check claims.

Heres what you need to know about the key deletions effective April 1.

CCI Ousts Erroneous 93296 Edits

CCI has deleted two edits that the Heart Rhythm Society referred to as a major error (

These edits, part of the January 2009 CCI 15.0 release, created roadblocks to properly coding professional and technical services for the new remote device checks,says Sarah Tupper, CMC, coder for Central New York Cardiology in Utica.

The codes: The edits prohibited billing technical code 93296 (Medicare national rate of roughly $36) with professional service codes 93294 ($37) and 93295 ($66):

" Professional: 93294 --Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim physician analysis, review(s) and report(s)

" Professional: 93295 -- & single, dual, or multiple lead implantable cardioverter-defibrillator system with interim physician analysis, review[s] and report[s])

" Technical: 93296 -- & single, dual, or multiple lead pacemaker system or implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results

Problem: The same organization often provides both the technical and professional portions, so the edits resulted in denials of correctly coded services, says Jim Collins,CCC, CPC, ACS-CA, CHCC, president of CardiologyCoder.Com in Saratoga Springs, N.Y.

Adding to the problem, the edits had a modifier indicator of 0, so you could not use a modifier to override them, Collins says.

Good news: CCI 15.1, effective April 1, retroactively deletes these edits. The retroactive deletion means that you may resubmit or appeal claims denied because of the edits. Or if you held claims for dates of service before April 1 because you knew the deletion was coming, now is the time to submit those claims.

CCI Deletes +93320, +93325 Edit,Too

CCI 15.1 also deletes the edit bundling +93325 (Doppler echocardiography color flow velocity mapping) into +93320 (Doppler echocardiography, pulsed wave and/or continuous wave with spectral Doppler display).

These edits are also retroactive to their January creation.

This deletion simplifies claims for coders who have been encountering problems reporting both +93320 and +93325 with 93351 (Echocardiography, transthoracic,real-time with image documentation [2D], includes Mmode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report; including performance of continuous electrocardiographic monitoring, with physician supervision).

Reality: You could use a modifier to override this edit (it had a modifier indicator of 1), many coders found insurers still had problems processing these claims.