Cardiology Coding Alert

Don't miss the 'congenital' focus of 93563-93564.

The countdown to 2011 has begun, so there's no time like the present to start easing your practice into the CPT Codes 2011 changes that will be in effect on the first day of the year. Start your preparations with this preview of some of the new and revised descriptors that may affect your cardiology coding.

Watch for: Look to future issues of Cardiology Coding Alert to bring you details on how the AMA intends you to use these codes. We'll bring you reports straight from the AMA's CPT and RBRVS 2011 Annual Symposium.

Prepare for Cardiac Cath Coding Overhaul

CPT 2011 brings major code changes for cardiac catheterization codes, says Terry A. Fletcher, BS, CPC, CCS-P, CCS, CEMC, CCC, CMSCS, CMC, a healthcare coding consultant based in Laguna Beach, Calif. One aspect of that change is that many of the new injection codes appear to be add-on codes, she notes. "I think it will be interesting to see what the fee schedule has allowed for these services to really get a grasp of how it will affect the cardiology practices for 2011," she says.

We'll go into more detail on proper use of the new codes once the AMA has released details, but you can get a hint of what's to come by looking at the new injection procedure codes. Note that these codes include both (1) the injection procedure during cardiac cath and (2) imaging supervision, interpretation, and report:

• 93563 -- Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective coronary angiography during congenital heart catheterization (List separately in addition to code for primary procedure)
• 93564 -- ... for selective opacification of aortocoronary venous or arterial bypass graft(s) (e.g., aortocoronary saphenous vein, free radial artery, or free mammary artery graft) to one or more coronary arteries and in situ arterial conduits (e.g., internal mammary), whether native or used for bypass to one or more coronary arteries during congenital heart catheterization, when performed (List separately in addition to code for primary procedure)
• 93565 -- ... for selective left ventricular or left atrial angiography (List separately in addition to code for primary procedure)
• 93566 -- ... for selective right ventricular or right atrial angiography (List separately in addition to code for primary procedure)
• 93567 -- ... for supravalvular aortography (List separately in addition to code for primary procedure)
• 93568 -- ... for pulmonary angiography (List separately in addition to code for primary procedure).

Deletion alert: As a consequence of these additions, reports indicate CPT 2011 will delete 2010 codes 93539-93545 (Injection procedure during cardiac catheterization ...) and 93555-93556 (Imaging supervision, interpretation and report for injection procedures during cardiac catheterization ...).

Count on More to Come for Coronary Angiography Options

You also may wonder why the new injection procedure codes for coronary angiography (93563-93564) specify "congenital heart catheterization." It appears you'll have other options for noncongenital cases.

That's because another one of the major changes you can expect is the addition of a new, eight-code family, 93454-93461 (Catheter placement in coronary artery[s] for coronary angiography, including intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation ...). The codes in the family differ based on whether you're reporting additional imaging or heart catheterization services performed at the same session.

Keep an eye out for future Cardiology Coding Alert articles on these and other new cardiac cath codes.