Wiki ECP External Counterpulsation - G0166

mmce

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Does anybody know what documentation is required to support this code? The provider I'm reviewing uses a treatment record form and I don't think it's capturing all that is needed to support?

Thanks, Meg
 
EECP requirements

EECP therapy is covered by the Center for Medicare and Medicaid Services
(CMS) and many insurance companies for patients who have been diagnosed
with disabling angina (Class III or Class IV, Canadian Cardiovascular Society
Classification or equivalent classification) who in the opinion of a cardiologist or cardiothoracic surgeon are refractive to optimal medical therapy and not readily amenable to surgical intervention such as percutaneous transluminal coronary angioplasty (PTCA) or cardiac bypass because their condition is inoperable, and/or their coronary anatomy is not readily amenable to such procedures, and/or they have co-morbid conditions which can create excessive risk.

Our physicians put a line in the cath report stating the class of angina and due to their coronary anatomy, they are not amendable for further procedures.

Hope this helps!

Jennifer Everett, CPC
 
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