Give Old Device Interrogation Codes the Heave-Ho in January
CPT 2009 shells out definitions galore to help decipher new monitoring codes. If you know the 93727-93736 series (Electronic analysis ...) for pacemaker and defibrillator interrogation by heart, take care. That range will go by the wayside Jan. 1, when CPT deletes the whole code series, as well as 93741-93744 (Electronic analysis of pacing cardioverter-defibrillator ...) and 93760-93762 (Thermogram ...). In place of these trusted cardiology codes, you'll find a whole new section titled "Cardiovascular Device Monitoring -- Implantable Devices," with a code range from 93279 (Programming device evaluation with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with physician analysis, review and report; single lead pacemaker system) through 93299 (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). Don't Expect Crosswalk to Be a Cakewalk According to notes in CPT where the old device interrogations used to be, you can use the following crosswalk as a reference. But watch out -- "careful review of the new codes illustrates that there is much more to adapting to the new codes than referencing a crosswalk," says Jim Collins, CCC, president of http://CardiologyCoder.Com. For example, new remote interrogation codes span all remote and nonprogramming in-person interrogations provided for a 90-day period of time. But programming interrogations (which do not necessarily require reprogramming of the device) are separately billable, Collins explains. Plus, CPT introduced new codes for implantable cardiovascular monitors, a new telephonic pacemaker interrogation service (also covering a 90-day period of time), and on/off programming before and after surgery (peri-procedural) services, he says. Deleted codes 2009 crosswalk 93727 93285, 93291, 93298 93731 93280, 93288, 93294 93732 93280, 93288, 93294 93733 93293 93734 93279, 93288, 93294 93735 93279, 93288, 93294 93736 93293 93741 93282, 93289, 93292, 93295 93742 93282, 93289, 93292, 93295 93743 93283, 93289, 93295 93744 93283, 93289, 93295 Reading the Guidelines Is a Must for Accuracy Bonus: For instance, CPT offers in-depth descriptions that help you differentiate between single-lead, dual-lead, and "multiple"-lead devices. In addition, you'll find explanations of implantable loop recorders, implantable cardiovascular monitors, programming interrogations, and other obscure concepts. "It's actually going to help a lot of people, I think," says Carla Whitmire, a biller with Strategic Coding Systems in Little Rock, Ark. "If CPT's going to give new codes for various types of devices, it would stand to reason that they'd explain what each device is to eliminate confusion. Usually CPT provides this type of information in its CPT Changes book," but this year the manual gives you a good head start, she says. Pay Special Attention to 93286 Peri-procedural code: CPT advises that you may "report 93286 once before and once after surgery, procedure, or test, when device evaluation and programming is performed before and after surgery, procedure, or test." "This code should be very useful" -- as long as payers offer decent reimbursement for it, Whitmire says. Medicare's global reimbursement for the code will be roughly $27, before adjusting for geographic location. And professional reimbursement will be roughly $15, according to the 2009 fee schedule. Take Out Your Red Pen or Risk 93285 Mistake Stay tuned for a more detailed look at these new codes in a future issue, but in the meantime, be sure you make a few corrections in your manual. 1. The name for the new section beginning after 93278 is printed as "Cardiovascular Device Monitoring -- Implantable and Wearable Devices." Cross out "and Wearable." 2. Be sure you catch the change to the note with new code 93285 (Programming device evaluation with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with physician analysis, review and report; implantable loop recorder system). The note should read: "(Do not report 93285 in conjunction with 33282, 93279-93284, 93291)." As printed, there is a comma rather than a hyphen between 93279 and 93284 ("93279, 93284" instead of "93279-93284"). But the AMA wants to make it clear that you shouldn't report 93285 with any of the codes in the range of 93279-93284. 3. The parenthetical note following 93298 (Interrogation device evaluation[s], [remote] up to 30 days; implantable loop recorder system, including analysis of recorded heart rhythm data, physician analysis, review[s] and report[s]) for implantable loop recorder system is missing a code, said Kenneth P. Brin, MD, PhD, FACC, CPT Editorial Panel member and cardiologist at Midwest Heart Specialists at SwedishAmerican Hospital in Rockford, Ill., speaking at the CPT and RBRVS 2009 Annual Symposium in Chicago. It should state: "(Do not report 93928 in conjunction with 33282, 93291, 93297.)" Resource: You can find CPT manual errata online at www.ama-assn.org/ama/pub/category/3896.html.
