Cardiology Coding Alert

Question: Is there a code for IABP monitoring and maintenance?

Codify Member

Answer: Experts recommend including the monitoring and maintenance for the intra-aortic balloon pump (IABP) when choosing the E/M level for the physician's subsequent services.

CPT® includes codes for insertion (such as 33967, Insertion of intra-aortic balloon assist device, percutaneous) and removal (such as 33968, Removal of intra-aortic balloon assist device, percutaneous), but there is no code specific to the monitoring.

Although it isn't directly on point, CPT® Assistant (April 2010) offers some insights in "Ventricular Assist Devices -- Insertion, Removal, Replacement." It focuses on ventricular assist device (VAD) insertion and removal codes 33975-33981. It states that for postoperative extracorporeal (outside the body) and intracorporeal (inside the body) VAD insertion care, coders should report the suitable critical care or E/M code, as appropriate.

Bonus tip: This code section also includes extracorporeal codes 33960 (Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial day) and 33961 (... each subsequent day). Because the definitions state "initial day" and "subsequent day," you may report these codes only once per day (with an appropriate E/M) when the patient is being treated using extracorporeal circulation over several days. Documentation should support medical necessity and indicate that all criteria of the services have been performed and met.