Cardiology Coding Alert

Reader Question:

E/M Covers CVD Marker Review

Question: When the cardiologist documents reviewing BNP and CRP lab results, how should we code this?

Pennsylvania Subscriber

Answer: You should include physician review of lab results in the medical decision making (MDM) portion of E/M. Most E/M score sheets give a single point for order/review of one or more lab tests.

The physician might request a brain natriuretic peptide (BNP) test for a patient with chest pain to evaluate the prognosis of a current cardiovascular event. The lab that performs BNP should bill 83880 (Natriuretic peptide).

The cardiologist might also order a C-reactive protein (CRP) test to evaluate inflammation that's related to heart disease risk. The lab that performs that test should report 86140 (C-reactive protein).

You may see these and other tests referred to as "CVD markers" because they could be an indicator for cardiovascular disease. The term does not encompass a specific test or set of tests, however, so the cardiologist's order and documentation of review should specify the precise tests.

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