Cardiology Coding Alert

Don't forget to check revisions -- CPT's still tinkering with wearable ECG recording.

Spoiler alert: CPT Codes 2011 has more new cardiology codes than you can shake a stick at. Revascularization, heart catheterization, observation services, and more all have new looks for the new year.

We'll go in-depth into the new codes in the coming months, bringing you insights straight from the November AMA CPT and RBRVS 2011 Symposium. To get you started, here's an overview of what you can expect.

37220-37235: Endovascular revascularization, open or percutaneous

The codes in this range are distinguished by the vessels involved: iliac, femoral/popliteal, and tibial/peroneal. Other distinguishing features include whether the physician performs angioplasty, stent placement, and/or atherectomy. For example, the definition of 37231 will be "Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal stent placement(s) and atherectomy, includes angioplasty within the same vessel, when performed."

• 93451-93464, 93563-93568: Cardiac catheterization and coronary angiography

If you like code range shake ups, you'll love this. These 20 new codes include options for reporting combinations of services, covering right and left heart caths, cath placement for coronary angiography, and injection procedures. For example, take a look at 93546 (Catheter placement in coronary artery[s] for coronary angiography, including intraprocedural injection[s] for coronary angiography, imaging supervision and interpretation; with right heart catheterization).

As a result of these additions, you'll have to say so long to some of your old favorites. Deleted codes will include 93501, 93508-93529, and 93539-93556.

• 99224-99226: Subsequent observation care

Subsequent day observation care also will get new codes, reportable per day. Pay special attention to these new codes as they will change the way you code an observation stay longer than 48 hours.

Stay tuned: The above new codes are just the start. You'll also have new Category III atherectomy and iliac repair codes effective Jan. 1. (You can check those out at www.ama-assn.org/ama1/pub/upload/mm/362/cptcat3codes.pdf.)

And several existing codes will see revisions, including iliac repair, angioplasty, non-coronary stent placement, wearable ECG recording, and noninvasive physiologic studies. (Hint: If you thought the descriptor for 93923, Noninvasive physiologic studies of upper or lower extremity arteries ..., couldn't get any longer, you're in for a surprise.)