# 90 min window-99241



## EmilyDingee (May 7, 2013)

So I got an interesting call from Coding Leader out of FL. The magazine is doing an article on code 99241. I advised him that since there was no documentation stating that code 92941 had to be with in 90 mins of MI that our practice was billing code 92941 per ICD-9 definition of "acute" MI (8 weeks). He sounded surprised and said that the majorityof coders he talked to was following the 90 min rule. I told him that there was no supporting documentation for this he advised me to google ACC/AHA Taskforce on practice guilelines-90mins. I did this and although it is stating for clinical purposes "The medical system goal is to facilitate rapid recognition and treatment of patients with STEMI such that door-to-needle (or medical contact–to-needle) time for initiation of fibrinolytic therapy can be achieved within 30 minutes or that door-to-balloon (or medical contact–to-balloon) time for PCI can be kept under 90 minutes." I dont see any reference to any CPT codes or coding guidelines. For now our practice will continue to use code 92941 up to 8 weeks for treatment of acute MI.


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## Jess1125 (May 7, 2013)

This was just address this week for MedLearn's Cardiology Question of the Week

http://panaceahealthsolutions.com/question-of-the-week/cardiology

Jessica CPC, CCC


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## samsaldukas@aol.com (May 21, 2013)

*93941*

There is an article in the May issue of their Cardiology document. There are also several case level breakdowns in an insert. If you'd like me to email you with a copy of the final details just let me know.

Thanks Sam


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## theresa.dix@tennova.com (May 22, 2013)

samsaldukas@aol.com said:


> There is an article in the May issue of their Cardiology document. There are also several case level breakdowns in an insert. If you'd like me to email you with a copy of the final details just let me know.
> 
> Thanks Sam



Sam,
 Would you please email that to me? Just to give a little information.I listen to Jim Collins and one of his handouts I have states that the definition of AMI and something to look for when reading the documentation is:

St elevation or Q wave AMI
Occlusion with dye staining at the site consistent with fresh thrombus.

So this tells me that the 8 weeks does not qualify using 92941 cpt. When someone has an Acute MI they are having it right then. If a person had a MI 8 weeks ago would he still have St elevation? Maybe? 

Thanks,


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## samsaldukas@aol.com (May 22, 2013)

Teresa - I'll get a copy right over to you.  The article basically digs in to the debate between the two camps and the reasoning behind both.  It also give several clinical examples.

Thanks sam


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## theresa.dix@tennova.com (May 22, 2013)

samsaldukas@aol.com said:


> Teresa - I'll get a copy right over to you.  The article basically digs in to the debate between the two camps and the reasoning behind both.  It also give several clinical examples.
> 
> Thanks sam



Sam,
 thanks that will be interesting.


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## Twixle2002 (May 23, 2013)

samsaldukas@aol.com said:


> There is an article in the May issue of their Cardiology document. There are also several case level breakdowns in an insert. If you'd like me to email you with a copy of the final details just let me know.
> 
> Thanks Sam



Sam Could you please email it to me as well? leahs.rao@gmail.com


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## CPCCODERII (May 23, 2013)

samsaldukas@aol.com said:


> Teresa - I'll get a copy right over to you.  The article basically digs in to the debate between the two camps and the reasoning behind both.  It also give several clinical examples.
> 
> Thanks sam



Could you please send a copy over to me too?  We have been questioning if we are coding these correctly so this article would be a great help  plowmanr@mercyhealth.com


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## HEMINGWAYT (May 24, 2013)

This issue was also addressed by Dr.Z of Zhealth Publishing back on 1/31/13.  Here is the quote from the newsletter:

"Since publication of our last newsletter, we have received a response from the AMA on their definition of an acute MI for coronary revascularization procedure coding.  They forwarded the question to the American College of Cardiology, who replied: "report for the patient haveing an ACUTE myocardial infarction with first medical contact to balloon within 90 minutes (for example).  CPT code 92941 can be reported for STEMI or NSTEMI."

We are following this guideline.


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## aeberle2 (May 28, 2013)

Can you please email me a copy as well? aeberle@pcvc.md


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## Twixle2002 (May 29, 2013)

HEMINGWAYT said:


> This issue was also addressed by Dr.Z of Zhealth Publishing back on 1/31/13.  Here is the quote from the newsletter:
> 
> "Since publication of our last newsletter, we have received a response from the AMA on their definition of an acute MI for coronary revascularization procedure coding.  They forwarded the question to the American College of Cardiology, who replied: "report for the patient haveing an ACUTE myocardial infarction with first medical contact to balloon within 90 minutes (for example).  CPT code 92941 can be reported for STEMI or NSTEMI."
> 
> We are following this guideline.



Tammy, Can you send me a copy of the newsletter please... Leahs.rao@gmail.com.  We do quite a few 92941 and I want to present this info to my physicians


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## EmilyDingee (Jun 4, 2013)

Could you please send a copy to me as well? Edingee@heartdocs.com

Thank you!


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## kmuerth (Jun 25, 2013)

I questioned this the other day. So are you guys knocking the CPT code back down to 92933 when stent, atherectomy, and angioplasty are done on an MI that is, oh say, 4 hours old? Or the 92928 when no atherectomy is done?


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## EmilyDingee (Jul 10, 2013)

samsaldukas@aol.com said:


> There is an article in the May issue of their Cardiology document. There are also several case level breakdowns in an insert. If you'd like me to email you with a copy of the final details just let me know.
> 
> Thanks Sam



HI Sam, Yes that would be Great! My Email is Edingee@heartdocs.com
Thank you!


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