Cardiology Coding Alert

Question: The inside cover of my CPT® manual shows modifier A1 for principal physician. I thought this was supposed to be modifier AI. Which is correct?

Utah Subscriber

Answer: Modifier AI (letter A, letter I) is appropriate for "Principal physician of record." Printing A1 was an error, as indicated in the AMA's "Corrections in CPT® 2011" document at www.ama-assn.org/ama/pub/physician-resources/solutionsmanaging-your-practice/coding-billing-insurance/cpt/aboutcpt/errata.page. The most recent update, as of printing time, was April 12, 2011.

You should be aware also of the correction to the note under 36215, which should read, "For catheter placement for coronary angiography, see 93454-93461."

And the second instruction above 75557 (Cardiac magnetic resonance imaging for morphology and function without contrast material) should read, "For cardiac catheterization procedures, see 93451-93572."

Under +93662 (Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation [List separately in addition to code for primary procedure]), check the parenthetical instruction to "Use 93662 in conjunction with ..." As printed, the third code listed is 93543. That is a typo, and you should delete the code. In its place, you should add 93453 (Combined right and left heart catheterization includin intraprocedural injection[s] for left ventriculography, imaging supervision and interpretation, when performed).

You also should check the index entry for Catheterization; Cardiac; Combined Left and Right. The subentries for Right Atrial and Right Ventricular should point you to 93566 (Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for selective right ventricular or right atrial angiography [List separately in addition to code for primary procedure]) instead of 93565.

Check the Corrections document regularly for updates. You also can read more about AMA errata in Cardiology Coding Alert, vol. 14, no. A, "93268-93272 Require Attended Surveillance -- Mark Your Guidelines Now."