Cardiology Coding Alert

Plus: Check out 4 other cardiology-related corrections to keep your coding on the straight and narrow.

 The list of corrections for the AMA CPT® manual has already reached more than 10 pages. Keep your coding in the clear by marking these changes in your manual and making sure your coding software is up-to-date. You’ll find corrections for patient-activated event recorders, 64-lead ECG, and more.

 Take the ‘Physician’ Requirement Out of Hospital Discharge

 The first change is a quick deletion in the guidelines for discharge codes 99238-99239 (Hospital discharge day management …). To make your guidelines current, delete the crossed out text: “These codes are to be utilized by the physician …”

 Rationale: As with many other codes and guidelines for 2013, CPT® removes the reference to the specific provider type. As a result, the guidelines no longer limit discharge services to physicians.

 93299 Joins Other Device Eval Codes in 33282 Instruction

 Another correction helps guide you to the proper code for analysis or reprogramming of an event recorder. Be sure to add the underlined code to this instruction following 33282 (Implantation of patient-activated cardiac event recorder):

• Initial implantation includes programming. For subsequent electronic analysis and/or reprogramming, use 93285, 93291, 93298, 93299.

 The added code, 93299, is defined as “Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular monitor system or implantable loop recorder system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results.”

 Stent Note’s Spelling Correction May Raise Questions

 The next modification is small, but it will appeal to those who are sticklers for spelling.

 CPT® 2013 revises one of the instructional notes under 37205 (Transcatheter placement of an intravascular stent[s] [except coronary, carotid, vertebral, iliac, and lower extremity arteries], percutaneous; initial vessel).

 The only tweak is to correct the spelling of “transcatheter” in the note which was published as: “For transcatherter coronary stent placement, see 92928-92944.”

 Note: At the time of this article’s publication, the AMA corrections list includes the old 2012 note, which refers to 2012 codes 92980 and 92981 rather than 2013 codes 92928-92944. Presumably this is a mistake, as CPT® 2013 deleted 92980 and 92981 and replaced them with codes in the 92928-92944 range.

 Return ECG Note to 2012 Wording

 If you ever code for 64-lead electrocardiograms (ECGs), you may be confused by a CPT® 2013 note for cardiography.

 In 2012, the notes preceding codes 93000-93042 stated, “For electrocardiogram, 64 leads or greater, with graphic presentation and analysis, see 0178T-0180T.” The referenced codes describe “Electrocardiogram, 64 leads or greater, with graphic presentation and analysis …” These codes were added in 2008.

 The 2013 manual, as printed, mistakenly advises, “For electrocardiogram, 64 leads or greater, with graphic presentation and analysis, use 93799.”

 The corrections document changes the note back to the 0178T-0180T reference rather than pointing to unlisted code 93799 (Unlisted cardiovascular service or procedure).

 TAVR Note Alludes to Nonexistent Code

 If you work with a team that provides catheter-delivered aortic valve replacement, share this correction with the group.

 Background: In 2012, you reported Category III codes 0256T-0259T for transcatheter aortic valve replacement. CPT® 2013 replaces those code with dedicated Category I codes 33361-+33369 (Transcatheter aortic valve replacement [TAVR/TAVI] with prosthetic valve …), noted the cardiothoracic surgery presentation by Peter K. Smith, MD, of the Society of Thoracic Surgeons, at the CPT® and RBRVS 2013 Annual Symposium.

 The one number missing in the 33361-33369 range is 33366. Between 33365 and +33367 you’ll instead see a note to “use 0318T for transapical approach [e.g., left thoracotomy.” Code 0318T is defined as “Implantation of catheter-delivered prosthetic aortic heart valve, open thoracic approach, [e.g., transapical, other than transaortic]).

 Problem: In the 2013 Category III section, a note states, “0258T has been deleted. To report, see 33365, 33366.” Recall that the final code listed, 33366, is not a valid code.

 Solution: The corrected note changes the last code to reflect the appropriate option: “0258T has been deleted. To report, see 33365, 0318T.”

 Resource: The AMA updates the corrections document throughout the year, so it’s smart to check it regularly. You can access it from www.ama-assn.org/go/cpt-errata, according to Peter Hollmann, MD, chair of the CPT® Editorial Panel in his Symposium presentation, “Moving CPT ® Into the Future.” Corrections are made based on review and comments from staff, panel, specialty societies, and anyone else interested in CPT®, said Hollmann.