Cardiology Coding Alert

Hint: T-codes are also known as Category III Codes.

CPT^® 2022 becomes effective on Jan. 1, 2022, so you’ll want to make sure you are familiar with all the new cardiology T-codes. Among your new choices, you’ll see new codes related to transcatheters, cardiac function systems, and body surface activation mapping for pacemakers.

Don’t miss: You’ll find the T-codes section toward the back of your CPT^® book. T-codes, also known as Category III Codes, are “temporary codes for emerging technology, services, procedures, and service paradigms. Category III codes allow for the collection of specific data,” according to CPT^®. Payment for these codes is not guaranteed, and you’ll need to work out the details with your payers before reporting any T-codes, so you’ll know if the service is covered.

Learn more to make sure you always submit clean claims in your cardiology practice.

Take a Look at New Transcatheter Codes

In 2022, you will gain some new transcatheter T-Codes. They are as follows:

• 0643T (Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach). Note: You should never report code 0643T in conjunction with fluoroscopy code 76000, per the CPT^® guidelines. Additionally, code 0643T includes the primary arterial vascular access and contralateral arterial access and percutaneous access site closure when your cardiologist performs these services.
• 0644T (Transcatheter removal or debulking of intracardiac mass (eg, vegetations, thrombus) via suction (eg, vacuum, aspiration) device, percutaneous approach, with intraoperative reinfusion of aspirated blood, including imaging guidance, when performed). Note: You should report code 0644T when your cardiologist performs transcatheter percutaneous removal or debulking of intracardiac vegetations, such as endocarditis, or masses, like a thrombus, with a suction device, according to the CPT^® guidelines.
• 0645T (Transcatheter implantation of coronary sinus reduction device including vascular access and closure, right heart catheterization, venous angiography, coronary sinus angiography, imaging guidance, and supervision and interpretation, when performed). Note: If your cardiologist performs intracardiac echocardiography (93662) along with the 0645T service, it is included so you cannot report the service separately, per the CPT^® guidelines.
• 0646T (Transcatheter tricuspid valve implantation (TTVI)/replacement with prosthetic valve, percutaneous approach, including right heart catheterization, temporary pacemaker insertion, and selective right ventricular or right atrial angiography, when performed). Note: You should never report code 0646T in conjunction with codes 33210 (Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure)) or 33211 (Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)) for temporary pacemaker insertion, according to the CPT^® guidelines.
• 0659T (Transcatheter intracoronary infusion of supersaturated oxygen in conjunction with percutaneous coronary revascularization during acute myocardial infarction, including catheter placement, imaging guidance (eg, fluoroscopy), angiography, and radiologic supervision and interpretation). Note: You should report code 0659T in conjunction with revascularization code 92941, per the CPT^® guidelines.

Discover New Cardiac Function System, Lead, Generator Codes

You will also find numerous new codes that deal with cardiac function, including insertion, repositioning, and replacement

Laparoscopic codes: For laparoscopic options, you will gain the following new codes:

• 0674T (Laparoscopic insertion of new or replacement of permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including an implantable pulse generator and diaphragmatic lead(s))
• 0675T (Laparoscopic insertion of new or replacement of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first lead) and +0676T (… each additional lead (List separately in addition to code for primary procedure))
• 0677T (Laparoscopic repositioning of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, including connection to an existing pulse generator; first repositioned lead) and +0678T (…each additional repositioned lead (List separately in addition to code for primary procedure))
• 0679T (Laparoscopic removal of diaphragmatic lead(s), permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function)

Don’t miss: You should report add-on code +0676T in conjunction with primary 0675T and add-on code +0678T in conjunction with primary code 0677T, according to the CPT^® guidelines. Also, you should report code 0679T only once regardless of the number of leads your cardiologist removed.

Pulse generators: When it comes to services involving pulse generators with cardiac function systems, you will gain the following new codes:

• 0680T (Insertion or replacement of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing lead(s))
• 0681T (Relocation of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function, with connection to existing dual leads
• 0682T (Removal of pulse generator only, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function)

Programming and device evaluation: Finally, you will also see some new programming and device evaluation codes such as 0683T (Programming device evaluation (in-person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function) and 0684T (Peri-procedural device evaluation (in-person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review, and report by a physician or other qualified health care professional, permanent implantable synchronized diaphragmatic stimulation system for augmentation of cardiac function).

Dial Into New Body Surface Activation Mapping Pacemaker Codes

You will also see two new codes for body surface–activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s). These include 0695T (Body surface–activation mapping of pacemaker or pacing cardioverter-defibrillator lead(s) to optimize electrical synchrony, cardiac resynchronization therapy device, including connection, recording, disconnection, review, and report; at time of implant or replacement) and 0696T (… at time of follow-up interrogation or programming device evaluation).

Don’t miss: You should report code 0695T in conjunction with pacemaker/implantable defibrillator codes 33224-33226, per the CPT^® guidelines. Also, you should report code 0696T in conjunction with device evaluation and programming codes 93281, 93284, and 93286-93289.