Cardiology Coding Alert

Primary code updates make a big difference for your +93463 claims.

If your shiny new CPT® 2014 manual has arrived, the time has come to start adding your own notes to it. The AMA has updated its 2014 (and 2013) Errata and Technical Corrections document with some changes you need to know.

Tip: Don’t forget to check your electronic coding resources for these changes, too.

1. Add 4 Codes to +93463’s List of Primary Options

The AMA correction documents for both 2013 and 2014 revise the parenthetical note with +93463 (Pharmacologic agent administration [e.g., inhaled nitric oxide, intravenous infusion of nitroprusside, dobutamine, milrinone, or other agent] including assessing hemodynamic measurements before, during, after and repeat pharmacologic agent administration, when performed [List separately in addition to code for primary procedure]).

Revision: The change adds the underlined codes and deletes the crossed out codes:

“(Use 93463 in conjunction with 93451-93453, 93456-93461, 93530, 93531, 93532, 93533, 93563, 93564, 93580, 93581).”

The two deleted codes are cardiac cath injection add-on codes codes:

• +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, Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; 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).
  

The added codes are congenital cardiac cath codes. These codes are now listed as possible primary codes for +93463:

• 93530, Right heart catheterization, for congenital cardiac anomalies
  
• 93531, Combined right heart catheterization and retrograde left heart catheterization, for congenital cardiac anomalies
  
• 93532, Combined right heart catheterization and transseptal left heart catheterization through intact septum with or without retrograde left heart catheterization, for congenital cardiac anomalies
  
• 93533, Combined right heart catheterization and transseptal left heart catheterization through existing septal opening, with or without retrograde left heart catheterization, for congenital cardiac anomalies.
  

2. Don’t Let 93799 Note Derail 64+ Lead ECG Claims

The CPT® 2014 document also corrects a parenthetical note at the end of the Cardiography guidelines: (For electrocardiogram, 64 leads or greater, with graphic presentation and analysis, see 0178T-0180T use 93799).

The CPT® 2013 corrections document posted this same correction in September of 2012.

The change points you to Category III codes 0178T-0180T (Electrocardiogram, 64 leads or greater, with graphic presentation and analysis …) instead of unlisted procedure code 93799 (Unlisted cardiovascular service or procedure). The Cat. III codes are specific to 64+ lead ECG, so reporting the unlisted code instead would be inappropriate, according to CPT® guidelines for Cat. III codes.

Resource: Check This Site Regularly

The complete lists of revisions are available on the AMA’s Errata and Technical Corrections page at www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt/errata.page.

The documents on this page will help you keep tabs on changes to CPT® codes throughout the year.