Medical Billing and Coding industry in 2013, has embraced several changes including some updates in Cardiovascular Coding, putting lots of emphasis on Percutaneous Coronary Intervention (PCI) and Ablation Codes.
Cardiology CPT Changes 2013Cardiology CPT Codes 92980, 92981, 92982, 92995 and 92996 will no longer be in use as they have been replaced with a set of 13 other new CPT Codes for classification purposes.
New codes for Transcatheter Aortic Valve Replacement (TAVR), Percutaneous Ventricular Assist Devices (PVAD) and Carotid Angiography have also been in use since the beginning of the year.
Ablation Codes ChangesFive new codes and guidelines will take effect aiding in the bundling of ablations together with a comprehensive Electrophysiological evaluation. New codes for Atrial Fibrillation will also take effect in this year of CPT changes. CPT codes 93651 and 93652 have been removed and replaced with CPT codes 93653 and 93657.
Cervicocerebral Angiography CPT CodesThe New CPT codes for Cervicocerebral Angiography will be used to describe non-selective and selective Arterial Catheter Placement and diagnostic imaging of the Aortic Arch, Carotid and Vertebral Arteries.
Eight new codes are in use in Cervicocerebral Angiography ranging from 36221-36228. Codes 36221-36226 will be used for accessing the vessel, placement of catheter(s), contrast injection(s), fluoroscopy, radiological supervision and interpretation, and closure of the arteriotomy by pressure, or application of an arterial closure device.
PCI Codes ChangesExtensive range of introductory languages were created and are being used by physicians and coders to assist in the Medical Billing Process and are also being used in the new PCI list of services.
PCI codes in use are built on a progressive hierarchy. The PCI codes now include the work of accessing and selectively catheterizing the vessel, traversing the lesion, radiological supervision and interpretation directly related to the intervention(s) performed, closure of the arteriotomy when performed through the access sheath, and imaging performed to document completion of the intervention in addition to the intervention(s) performed.
PVAD (Percutaneous Ventricular Assist Device) new CodesFour new Percutaneous Ventricular Assist Device (PVAD) CPT codes have taken effect for the insertion removal and repositioning of Ventricular assist device percutaneously.
Five new codes are also in use for foreign body removal and Trans¬catheter Thrombolytic Infusion i.e 37197 and 37211 – 37214. The new parenthetical for Aortography CPT codes are 75600-75605, 75635–75658, and 75746-75791.
If a physician performs any arterial capillary or venous phase imaging you will not have to report it separately as all of them are included in the codes 36221-36228
TAVRACC worked extensively on Multi-specialty code changes in TAVR codes thereby introducing Eight new CPT codes and guidelines ranging from 33361-33369.
Under the CMS-issued National Coverage Determination (NCD) regarding TAVR, which falls under "Coverage with Evidence Development" (CED), both a Cardiothoracic Surgeon and an Interventional Cardiologist must perform the procedure.
Claims processing instructions for the CED (CR 7897 transmittal 2552) require each physician to bill with modifier-62, indicating that co-surgery payment applies. Medicare pays each co-surgeon 62.5 percent of the fee schedule amount.
Cardiac Implantable and Wearable Device EvaluationThe codes (93729-93298) are being used to incorporate the language review and report by a physician or other qualified health care professional.
CPT codes 93279-93292 will essentially be used on the Diagnostic Cardiovascular Services subject to the Multiple Procedure Payment Reduction (MPPR) table.
Cardiologist Medicare Physician Fee ChangesMedicare Physician fee have experienced some changes with centers for Medicare and Medicaid services receiving a bundle a different codes for payment.
Among the changes to be experienced include those of CMS rebundling work associated with placement of a stent in an arterial branch into the base code for the placement of a stent in an artery instead of paying for the additional branches.