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HELP! Possible new job as Cardiothoracic Coder!!

  1. #1
    Exclamation HELP! Possible new job as Cardiothoracic Coder!!
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    Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what CPT codes go with what procedures and what the most important things I need to learn to get my foot in the door are. Thanks for your help!
    Chrissy, CPC

  2. #2
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    Richardson, TX
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    AVR - 33405 (most common - with my docs); 33411 - AVR with annulus enlargement

    MV Repair/Replacement - Repair; 33425, 33426 (with prosthetic ring), 33427 (radical reconstruction i.e. chords). Replacement; 33430; left atrial appendage is included with MVR not separately billable

    CABG -
    Artery only 33533-33536
    Vein only - 33510-33516
    Artery/vein (add0-on codes) - 33517-33523
    33508 - MUST say endoscopic harvest to bill

    33530 - reoperation. Can only be used with CABG and Valve codes. Must be one month from original DOS.

    Atrial Septal defect - 33641
    ASD/VSD - 33647

    AAA
    depends on graft placement for primary code 34802-34804/75952
    Can bill for cath placement in Aorta 36200 - 50
    IVUS - 37250/37251 S&I 75945/75946
    Femoral cutdown 34812
    Extensions - 34825/34826/75953

    To start...
    Last edited by jewlz0879; 10-20-2011 at 01:11 PM.
    Julie Graham, BA, CPC, CCC

  3. #3
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    Richardson, TX
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    Diagnostic Thoracoscopy/Surgical Thoracoscopy 32601-32606
    All six diag thoracoscopies are bundled to any of the surgical. Diagnostic thoracoscopy should not be billed if surgical was performed at same session, unless the diagnostic resulted in decision to perform surgery and in that case append mod - 58. Some private payors might rather have -59 instead of the 58.

    You can bill multiple surgical thoracoscopies (32650-326665) if two separate techniques are performed at different sites and append 59 to lesser-valued procedure. Ex: 32663 and 32650 -59.

    Thoracotomy - half-moon incision, no scope, rib spreaders may be used. These codes describe incisions into the chest. Whereas Thoracoscopies are done with a scope.

    32095 - 32225
    Julie Graham, BA, CPC, CCC

  4. #4
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    Quote Originally Posted by HILLIC View Post
    Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what CPT codes go with what procedures and what the most important things I need to learn to get my foot in the door are. Thanks for your help!
    Good luck! CT surgery is very exciting and challenging. I love it! I just love cardiology and Cardiothoracic/Vascular. LOL
    Julie Graham, BA, CPC, CCC

  5. #5
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    Thank you all so much for your help! I am writing everything down so I have it in my notes in case I get the job. It does sound like a very interesting field. I love coding surgery so this might be right up my alley. I've been reading a lot of your posts and recognize some of your names and hope that if I get the job, we can keep in contact because I'm sure I will need some help in the weeks to come! Thanks again, you all rock!!
    Chrissy, CPC

  6. #6
    Wink
    Quote Originally Posted by HILLIC View Post
    Thank you all so much for your help! I am writing everything down so I have it in my notes in case I get the job. It does sound like a very interesting field. I love coding surgery so this might be right up my alley. I've been reading a lot of your posts and recognize some of your names and hope that if I get the job, we can keep in contact because I'm sure I will need some help in the weeks to come! Thanks again, you all rock!!
    Ok, Julie, I just realized that all this info came from just you! Thanks so much, I really do appreciate it. Maybe I can go in to the interview with a little more knowledge now than I had before which was none! Thanks again for taking the time to help me!
    Chrissy, CPC

  7. #7
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    Quote Originally Posted by HILLIC View Post
    Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what CPT codes go with what procedures and what the most important things I need to learn to get my foot in the door are. Thanks for your help!
    Quote Originally Posted by HILLIC View Post
    Ok, Julie, I just realized that all this info came from just you! Thanks so much, I really do appreciate it. Maybe I can go in to the interview with a little more knowledge now than I had before which was none! Thanks again for taking the time to help me!
    It's all good! So glad I could help. I love gettin on the AAPC boards and just seeing if I can answer someone's question(s). There are others that are probably more CT saavy than myself but I've been doing cardiology for about 3 years and CT surgery a little over 1 year. LOVE, LOVE, LOVE IT! I do hope you get the job and you are more than welcome to email me with any questions and I'll be happy to help.
    Julie Graham, BA, CPC, CCC

  8. #8
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    Thanks! I'm glad to hear that you love it so much, maybe that means I will too! It sounds and looks like I will have a lot to learn but it will be cool stuff to learn. I will definitely be looking you up if I get this position, thanks for the well wishes!
    Chrissy, CPC

  9. #9
    Talking I was in a similar situation
    [QUOTE=HILLIC;184585]Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what CPT codes go with what procedures and what the most important things I need to learn to get my foot in the door are. Thanks for your help![/QUOTE

    I was in a similar situation recently, but my background was ortho. I was hired to do ortho, general surgery and cardio thoracic. I was a little scared by CV at first, but google is my best friend. Like for CABGs my MD uses a lot of obscure acronyms I’m not familiar with and can’t find in my medical dictionary, so I type in “define xwz” and get the proper name of the vessel. I found it made me more comfortable to read the cardio section over several times in the days before I started.
    You may want to ask your potential employer if your new CV position has interventional radiology components, and if training can be provided. It’s better to be forewarned.
    I found out, after I was hired, even my manager was not aware of at the time, my cardio thoracic guy is more in the interventional radiology side of things. So I’ve had to take courses, this was the only aspect of my new job I could not teach myself. I was very pleasantly surprised when I went to my manager, explained the difference between IVRCC and Cardio Thoracic and that with the extreme complexity of interventional I needed education, and was provided the classes I needed. My company even paid for it. In a ways I’m kind of glad I didn’t know, I might not have accepted the position, because even the words interventional radiology use to make me cringe. This would have been horrible, because I’m doing well in my new job and love it. I’ve even taken on OBGYN this week as well.

  10. #10
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    Richardson, TX
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    [QUOTE=nrichard;184719]
    Quote Originally Posted by HILLIC View Post
    Hello! I have been a coder for 4 years and have coded General Surgery and Hematology and Oncology. I have relocated and have an interview next week but do not have a CPT book with me to look at. I was wondering if any of you who already code cardiothoracic would give me some hints as to what CPT codes go with what procedures and what the most important things I need to learn to get my foot in the door are. Thanks for your help![/QUOTE

    I was in a similar situation recently, but my background was ortho. I was hired to do ortho, general surgery and cardio thoracic. I was a little scared by CV at first, but google is my best friend. Like for CABGs my MD uses a lot of obscure acronyms I'm not familiar with and can't find in my medical dictionary, so I type in “define xwz” and get the proper name of the vessel. I found it made me more comfortable to read the cardio section over several times in the days before I started.
    You may want to ask your potential employer if your new CV position has interventional radiology components, and if training can be provided. It's better to be forewarned.
    I found out, after I was hired, even my manager was not aware of at the time, my cardio thoracic guy is more in the interventional radiology side of things. So I've had to take courses, this was the only aspect of my new job I could not teach myself. I was very pleasantly surprised when I went to my manager, explained the difference between IVRCC and Cardio Thoracic and that with the extreme complexity of interventional I needed education, and was provided the classes I needed. My company even paid for it. In a ways I'm kind of glad I didn't know, I might not have accepted the position, because even the words interventional radiology use to make me cringe. This would have been horrible, because I'm doing well in my new job and love it. I've even taken on OBGYN this week as well.
    I wanna come work with you! I'd love to learn Ortho and OBGYN. I hear they are both pretty challenging. That is awesome.
    Julie Graham, BA, CPC, CCC

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