Cardiology Coding Alert

Remember: Never report add-on codes alone on your claims.

When CPT^® 2023 becomes effective on Jan. 1, 2023, you’ll see many new codes, deletions, and revisions. Cardiology practices should especially be aware of the new pulmonary artery revascularization codes, percutaneous arteriovenous fistula creation codes, and injection codes.

Here’s what you need to know to keep your claims squeaky clean next year.

Mark Down New Pulmonary Artery Revascularization Choices

In 2023, you will gain the following new percutaneous pulmonary artery revascularization codes:

• 33900 (Percutaneous pulmonary artery revascularization by stent placement, initial; normal native connections, unilateral)
• 33901 (… normal native connections, bilateral)
• 33902 (… abnormal connections, unilateral)
• 33903 (… abnormal connections, bilateral)
• +33904 (Percutaneous pulmonary artery revascularization by stent placement, each additional vessel or separate lesion, normal or abnormal connections (List separately in addition to code for primary procedure))

Don’t miss: To choose the correct code from above, check your cardiologist’s documentation to see if the connections are abnormal or normal and unilateral or bilateral.

Pinpoint 2 New Fistula Creation Codes

You will see two new percutaneous arteriovenous fistula creation codes in 2023.

Report 36836 (Percutaneous arteriovenous fistula creation, upper extremity, single access of both the peripheral artery and peripheral vein, including fistula maturation procedures (eg, transluminal balloon angioplasty, coil embolization) when performed, including all vascular access, imaging guidance and radiologic supervision and interpretation) when your cardiologist uses single access of both the peripheral artery and vein.

On the other hand, report 36837 (Percutaneous arteriovenous fistula creation, upper extremity, separate access sites of the peripheral artery and peripheral vein …) when your cardiologist uses separate access sites of the peripheral artery and vein.

“The new fistula creation codes, 36836 and 36837 are for a non-surgical, minimally invasive procedure, which allows for a shorter healing time,” says Robin Peterson, CPC, CPMA, manager of professional coding services, Pinnacle Integrated Coding Solutions, LLC in Centennial, Colorado. “When reviewing this procedure documentation, expect to see both an arterial catheter and a venous catheter inserted either through an incision or percutaneous access. Each catheter has a magnet, which then aligns while pulling the vessels together. One catheter will deliver a radiofrequency burst of energy and create the connection between the two vessels.”

Note New Add-on Injection Codes

Also, make sure to pay attention to several changes to injection codes in 2023.

First, code +93568 has been revised: Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for nonselective pulmonary arterial angiography (List separately in addition to code for primary procedure. (emphasis added.) As you can see, this code should only be reported for nonselective pulmonary arterial angiography.

Then, you will gain the following new add-on injection codes for selective pulmonary angiography:

• +93569 (… for selective pulmonary arterial angiography, unilateral (List separately in addition to code for primary procedure))
• +93573 (… for selective pulmonary arterial angiography, bilateral (List separately in addition to code for primary procedure))
• +93574 (… for selective pulmonary venous angiography of each distinct pulmonary vein during cardiac catheterization (List separately in addition to code for primary procedure))
• +93575 (… for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart defects, each distinct vessel (List separately in addition to code for primary procedure))

To choose the appropriate code, check the documentation for details such as if the selective pulmonary angiography was unilateral or bilateral, venous or arterial, or major aortopulmonary collateral arteries (MAPCAs).

Don’t miss: Add-on codes cannot be standalone codes. You must report the add-on code with an accompanying primary procedure code. An add-on code is indicative of an additional work that your physician does in a single session or patient encounter.

Observe Brand-New Category III Codes

Finally, don’t miss the following new Category III codes in 2023:

• +0715T (Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure))
• 0716T (Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score)
• 0744T (Insertion of bioprosthetic valve, open, femoral vein, including duplex ultrasound imaging guidance, when performed, including autogenous or nonautogenous patch graft (eg, polyester, ePTFE, bovine pericardium), when performed)
• 0745T (Cardiac focal ablation utilizing radiation therapy for arrhythmia; noninvasive arrhythmia localization and mapping of arrhythmia site (nidus), derived from anatomical image data (eg, CT, MRI, or myocardial perfusion scan) and electrical data (eg, 12-lead ECG data), and identification of areas of avoidance)-0747T (… delivery of radiation therapy, arrhythmia)

Don’t miss: You’ll find the Category III codes in the back of your CPT^® code book. Category II codes, also known as T-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.