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thrombectomy coding

  1. #11
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    Quote Originally Posted by dpeoples View Post
    I think I have a headache . We have a perfectly good code for this (cpt description does not specify mechanical) and the professional societies (ACC/AMA) have clouded the water. Why did they issue this new guideline? Perhaps they want to develope a new code?
    Fortunately for me, all the coronary thrombectomies I see are with an angioget (so far).

    stay tuned....
    For me, it the opposite. Suction using a pronto catheter.

    Jim

  2. #12
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    Quote Originally Posted by Jim Pawloski View Post
    I read the Medlearn answer, and it confused me even more. That's why I still bill for the thrombectomy until someone gives me an answer.

    Jim Pawloski, CIRCC
    We (MedLearn) asked CPT KnowledgeBase about 92973 because we don't agree with the ACC policy. We pointed out that the code didn't say "mechanical", we pointed to the 2002 CPT Changes description, etc.
    They answered back with ACC's response. Export catheter aspiration is not separately coded with an intervention. Angiojet is the only device that fits 92973 currently. To qualify for 92973 the device must mechanically fragment the clot.

  3. Default
    Quote Originally Posted by donnajrichmond View Post
    We (MedLearn) asked CPT KnowledgeBase about 92973 because we don't agree with the ACC policy. We pointed out that the code didn't say "mechanical", we pointed to the 2002 CPT Changes description, etc.
    They answered back with ACC's response. Export catheter aspiration is not separately coded with an intervention. Angiojet is the only device that fits 92973 currently. To qualify for 92973 the device must mechanically fragment the clot.

    Ok. that is how I understood it too. I guess that is how I will code it then unless I hear something different. Thanks!
    Theresa CCS-P CPMA CCC ICDCT-CM

  4. #14
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    Quote Originally Posted by donnajrichmond View Post
    We (MedLearn) asked CPT KnowledgeBase about 92973 because we don't agree with the ACC policy. We pointed out that the code didn't say "mechanical", we pointed to the 2002 CPT Changes description, etc.
    They answered back with ACC's response. Export catheter aspiration is not separately coded with an intervention. Angiojet is the only device that fits 92973 currently. To qualify for 92973 the device must mechanically fragment the clot.
    Thank you for the response to our question.
    Jim Pawloski,
    CIRCC

  5. #15
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    Thanks everyone for the threads. I only encounter aspiration thrombectomies and after reviewing the articles am also going to go on the advice of the article and use the unlisted code for these. (Even though I had a perfectly good code for this!)

    If there is any update to this in the future that anyone knows of please let me know!

    Jessica CPC, CCC

  6. #16
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    Quote Originally Posted by Jess1125 View Post
    Thanks everyone for the threads. I only encounter aspiration thrombectomies and after reviewing the articles am also going to go on the advice of the article and use the unlisted code for these. (Even though I had a perfectly good code for this!)

    If there is any update to this in the future that anyone knows of please let me know!

    Jessica CPC, CCC
    New from Dr. Z's website/ e-mail

    AMA Supports ACC Position on Use of Coronary Thrombectomy Code 92973


    The American Medical Association (AMA) has stated that they agree with the American College of Cardiology (ACC) that code 92973, Percutaneous transluminal coronary thrombectomy (List separately in addition to code for primary procedure), may only be used to report removal of thrombus utilizing a mechanical system. It may not be reported when thrombus is removed with an aspiration catheter.

    The AMA goes even further and states that removal of coronary thrombus by any means other than mechanical is not separately reportable. It is part of any other intervention performed. So, when thrombus is removed prior to percutaneous transluminal coronary angioplasty (PTCA) or coronary stent placement by a means other than use of a mechanical device, it is included in those procedures.


    Performance of an aspiration thrombectomy without another intervention is rare, but happens on occasion. Add-on code 92973 may not be utilized with aspiration devices. Unlisted code 93799 would be used to report a “stand-alone” aspiration thrombectomy of a coronary artery.


    According to the AMA, at this time the only catheter that meets the requirement for use of code 92973 is the Angiojet® (which includes the Angiojet Expedior®). All other catheters currently having FDA approval are not mechanical devices. The limitation on the use of code 92973 goes back to the American Medical Association Specialty Society Relative Value System Update Committee (RUC) description of procedure code 92973. The definition of the procedure was: utilization of a system that includes a drive unit, pump, and foot pedal. The physician steps on a foot pedal to activate the catheter which is then withdrawn across the lesion in order to remove the intracoronary thrombus.

    Code 92973 will have limited usage with the AMA's clarification on the intent of the code as many successful coronary artery thrombectomies are performed with aspiration catheters.


    HTH,
    Jim Pawloski, CIRCC

  7. #17
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    I was also disheartened to see this in the most recent Dr. Z newsletter, as my facility uses Pronto catheters almost exclusively for thrombectomies. According to the ACC, and now the AMA, aspiration thrombectomy is considered bundled into the intervention and therefore not billable at all, unlisted or otherwise.

    But now that AMA has agreed with ACC, I'm sure the CPT terminology will be modified in a future version, possibly even the 2012 version (although they're running out of time to make it into the 2012 version by October).
    ____________

    Rich Carrillo, CCS, CPC

  8. Default
    Quote Originally Posted by 131343 View Post
    I was also disheartened to see this in the most recent Dr. Z newsletter, as my facility uses Pronto catheters almost exclusively for thrombectomies. According to the ACC, and now the AMA, aspiration thrombectomy is considered bundled into the intervention and therefore not billable at all, unlisted or otherwise.

    But now that AMA has agreed with ACC, I'm sure the CPT terminology will be modified in a future version, possibly even the 2012 version (although they're running out of time to make it into the 2012 version by October).
    Well there ya go. Thanks Jim!
    Theresa CCS-P CPMA CCC ICDCT-CM

  9. #19
    Location
    Birmingham, Alabama
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    889
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    While I certainly believe Jim, I was wondering where I could find this information from publically available source. I have been unable to locate this news on the Zhealth website, or that of the AMA or ACC

    I need to show it to others but email from another coder will not suffice (no offense Jim )
    Does anyone have any ideas where I could find this?

    Last edited by dpeoples; 08-31-2011 at 02:26 PM.
    Danny L. Peoples
    CIRCC,CPC

  10. Default
    Quote Originally Posted by dpeoples View Post
    While I certainly believe Jim, I was wondering where I could find this information from publically available source. I have been unable to locate this news on the Zhealth website, or that of the AMA or ACC

    I need to show it to others but email from another coder will not suffice (no offense Jim )
    Any ideas?


    Jim,
    I didnt get the new newsletter from dr Z. Could you please send it to me?
    Theresa CCS-P CPMA CCC ICDCT-CM

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