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Cardiology Coding Alert
Cardiology Coding Alert
Cardiology Coding Alert - 2008; Volume 11, Number 12
Simplify 24-Hour Cardiac Monitoring Coding By Zooming In on 2 Details
Learn why you won't report global codes very often.You should focus on what technology you...
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Focus on PV:
Satisfy 3 Factors for Stent After Failed Angioplasty, Atherectomy
Peripheral interventions in the renal arteries are justified only in one instanceSuppose y...
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Reader Questions:
Check for Change of Pacemaker Battery Dx
Question: My cardiologist is changing the patient's pacemaker battery. What diagnosis code...
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Reader Questions:
Focus on EF PC/TC Indicator
Question: I have heard conflicting advice about whether modifier 26 is necessary when we r...
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Readers Questions:
Count Follow-Up Groin Checks as Part of E/M
Question: Our physicians do follow-up groin checks in the office after cardiac catheteriza...
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Reader Questions:
'Vessel Origin' Paramount for 75650
Question: Our physicians do follow-up groin checks in the office after cardiac catheteriza...
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Reader Questions:
Simplify How to Use Modifier 51 Symbol
Question: Can I use modifier 51 with 36620 when my cardiologist performs a catheterization...
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Reader Questions:
Don't Make This ECG Diagnosis Mistake
Question: If the cardiologist hasn't indicated the ECG results in his final diagnosis, sho...
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Reader Question:
Anatomic Modifiers Can Apply to Add-On Codes
Question: Should I use a modifier for 92981? We are getting denials as incidental to the p...
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Cardiology Coding Alert - 2008; Volume 11, Number 11
News You Can Use:
CCI Rescinds Controversial Policy Restricting Only One PV Intervention Per Vessel
Watch out: You will still have problems with the reinstated policy, experts sayNo more wil...
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News You Can Use:
Coding At-Home Prothombin Time Tests? CMS Expands Coverage
Don't miss: Counseling services can sometimes mean an E/M codePatients using warfarin (bra...
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News You Can Use:
Spot These Critical Care Indicators to Boost Your Bottom Line
Don't fall into the trap of under-reporting these services If you fail to heed a n...
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Reader Questions:
It's Not Too Late to Participate in PQRI
Question: Our cardiology practice did not begin the Physician Quality Reporting Initiative...
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Reader Questions:
Code CAD Diagnoses With Confidence
Question: I'm uncertain about when I should report 414.00 versus 414.01. What's the differ...
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Reader Questions:
Fluoro Documentation Necessary for 71090
Question: Should I refrain from using 71090 for fluoroscopy at the time of an ICD implant ...
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Reader Questions:
You Can Get Paid for Inconclusive Tests
Question: When my cardiologist performs a diagnostic test (for instance, an echocardiogram...
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Reader Questions:
Nix Cath Placement for Planned Interventions
Question: My cardiologist plans for and schedules a coronary interventional procedure (ang...
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You Be the Coder:
How to Report External Counterpulsation
Question: How should we report external counterpulsation (ECP)? Are practices still perfor...
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Cardiology Coding Alert - 2008; Volume 11, Number 10
Coding From the Doctor's Note:
Put Your First-, Second-Order Proficiency to This PV Case Study Test
Hint: Vascular families determine which codes you'll reportThink you can capture every ele...
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Split Professional, Technical Components Like a Pro
Purchasing power will change the rules for modifiers 26, TCReporting modifiers 26 (Profess...
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Capture Same-Day Cardio, EP Consults With This Expert Advice
This success story proves you can be victorious getting your claims paidConsultations don'...
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Reader Questions:
Here's What You Need for ICD Replacement
Question: My cardiologist removed an ICD lead, replaced it with a new one, and then tested...
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Reader Questions:
How to Code Post-Cath Discharges
Question: Our cardiologist performed a left heart cath and then discharged the patient. Ho...
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Reader Questions:
Be Wary of Routine Low-Level E/Ms with Coumadin Tests
Question: If my cardiologist performs a finger-stick Coumadin test, is it OK to report a l...
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Reader Questions:
Attack Your Atypical Chest Pain Dx Cases
Question: My doctor saw a patient for "atypical" chest pain. Which diagnosis code should I...
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Reader Questions:
Decide if PFO Warrants Congenital Echo Codes
Question: My cardiologist performed an echo and discovered a patent foramen ovale (PFO) th...
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You Be the Coder:
Unravel This 'Runoff' Coding Concept
Question: Can I bill for any "runoff" imaging services when my cardiologist performs a fem...
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Cardiology Coding Alert - 2008; Volume 11, Number 9
Clear Up Your Claims by Comparing Combined Cath Versus Ablation Transseptal Heart Codes
Here's why you should apply modifier 22 for ablation casesIf your transseptal atrial fibri...
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CCI 14.2 Update:
Heed This Slew of EKG Bundles or Trigger Massive Denials
CPT 93000 codes will now require meeting modifier 59 criteria If you're used to ta...
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Coding Quiz Questions:
Think You Can Handle Hypertension Dx Coding? Try This
What your physician documents is key If you incorrectly dig into hypertension ICD-9 cod...
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Coding Quiz Answers:
Prime Your Hypertension Skills With This ICD-9 Challenge
Surprise: You must indicate primary or secondary hypertensionTo avoid taking up your cardi...
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Reader Questions:
Don't Confuse 'Holter' With 'Event'
Question: What is the code for an event monitor? What is the difference between a Holter m...
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Reader Questions:
Tackle This Modifier 25 and EKG Scenario
Question: We've received letters from CMS regarding modifier 25. We use this modifier on t...
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Reader Questions:
Modifiers Matter for Left Cath, Stent Procedures
Question: Can I charge a cath (93510) and stent (92980) together when the same cardiologis...
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Reader Questions:
Reporting Renal CTA? Use 74175
Question: What is the appropriate CPT code for a renal CTA?Oklahoma SubscriberAnswer: You ...
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Reader Questions:
No Patient There? Don't Expect Payment
Question: Should we bill an office visit (99211-99215) for a consult with a family member ...
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Reader Questions:
What Makes a Clean Claim?
Question: Our cardiology practice has recently had to appeal numerous claims. The denial...
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You Be the Coder:
Get Modifiers Q0, Q1 Straight
Question: Should we append modifiers Q0 or Q1 on every ICD implant billed? Our MLN bulleti...
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Cardiology Coding Alert - 2008; Volume 11, Number 8
Please click on the pdf to view this issue- content to follow
...
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Prevent Unbundling and Underreporting of Intracoronary Stent Coding With 4 FAQs
Heads up: The number of coronary artery repairs will affect your claim You'll a...
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CPT Quiz:
Can You Code Intracoronary Stents? Test Yourself
Beware of reporting angioplasties that may be a part of stenting proceduresTake this quiz ...
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ICD-9 2009 Update:
Teach Doctors to Add Lipid Detail This Fall
You'll have secondary diabetes codes come OctoberYour 2009 ICD-9 book will increase by at ...
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4 Tips Speed Your Unlisted-Procedure Practices
Key: The report should use simple, straightforward languageYou can streamline your unliste...
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CPT Quiz:
Intracoronary Stent Placement Answers Revealed
Hint: Avoid coding more than once for a vessel's sub-branchesDid you absorb all the i...
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Reader Questions:
Code a Direct LDL Beyond Lipid Profile
Question: Is it appropriate to report a direct LDL beyond the calculated LDL included in a...
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Reader Questions:
Confront This Modifier 26 Advice
Question: I have heard conflicting advice about whether modifier 26 is necessary when we r...
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Reader Questions:
Apply A4216 for Saline With Bubble Study
Question: When a physician performs an in-office 2-D echocardiogram, should I report the s...
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Reader Questions:
Ace This Arrhythmia Attempt Scenario
Question: I have an electrophysiology (EP) study that indicates pacing from the right atri...
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Reader Questions:
Clear Up Consultation Confusion
Question: If my cardiologist sees a patient in January at the hospital and provides a cons...
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Reader Questions:
Check LCDs for Venous Disease Codes
Question: Should I use arterial disease codes 443.9, 440.21, 440.1, and 447.3 for venous...
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You Be the Coder:
How to Report What the Cardiologist Uses
Question: If the cardiologist uses 4.1 mCi of thallium, should I bill as 4 units or 5 unit...
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Cardiology Coding Alert - 2008; Volume 11, Number 7
Focus on PV Coding:
Prepare for CMS' New Guideline -- Even if It's Not Enforced
If Medicare has its way, you could be saying goodbye to $225You could feel a pinch in your...
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Coding From the Doctor's Note:
3 Steps Correct Your Cardiac Rhythm Device Claims
Warning: Unless the MD describes a fluoroscopy, you should not report itTo report failed p...
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Jump-Start Your ABNs Before the Sept. 1 Deadline
This is how the ABN form should changeCMS has unveiled its new advance beneficiary notice,...
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Reader Questions:
Don't Always Code Symptoms Last
Question: We get many complete carotid duplex reports that state weakness, syncope, mild p...
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Reader Questions:
Attack Ankle-Brachial Indexes
Question: Should I report ankle-brachial indexes separately from an E/M code?Michigan Subs...
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Reader Questions:
Perfect Your Pacer Pocket Treatment Coding
Question: A patient who had a pacemaker implanted on April 15 returned to the hospital wit...
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Reader Questions:
Distinguish a Type 2 Arch
Question: My cardiologist documented a "Type 2 Arch." What is that? Is this a bovine arch?...
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Reader Questions:
Pit 75605 Against 75650
Question: The cardiologist took images, but I don't know whether to report 75605 or 75650....
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Reader Questions:
Capture Personal History of Cardiac Death
Question: Recently, I encountered two new codes -- V12.53 and V17.41. When did they come o...
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You Be the Coder:
Cryoplasty Balloon Scenario
Question: My cardiologist's documentation indicates, "The patient underwent a peripheral a...
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Cardiology Coding Alert - 2008; Volume 11, Number 6
Version 14.1 Update:
Don't Miss Legit Chances to Override Edits Complicating 6 Cardio Services
CCI changes muddy the waters when you're reporting thoracentesis codesTEE, fluoro, and dru...
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Focus on PV:
Demystify Aortogram, Imaging Code Combos
Tracking catheter placement will safeguard you against coding mistakesYou know you will ne...
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Coding From the Doctor's Note:
Eliminate EPS Errors With This Example
Your add-on codes must include documentationPractice your comprehensive electrophysiology ...
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Reader Questions:
WTM Claims Require EKG Documentation
Question: I am confused about coding for "Welcome to Medicare" (WTM) exams. How can I tell...
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Reader Questions:
Include Phone Calls With E/M Service
Question: We normally report 36415 when patients present for Coumadin treatment, but our c...
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Reader Questions:
Add Angiogram if Procedure Was Diagnostic
Question: One doctor at our facility consistently documents that he performed a femoral an...
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You Be the Coder:
How to Report Critical Care
Question: A patient presented to the ED as critical care, and the cardiologist subsequentl...
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Cardiology Coding Alert - 2008; Volume 11, Number 5
Refresher Course:
Simplify Stress Test Claims by Reviewing Indications and Documentation Hazards
Tip: Make sure your physician documents direct supervisionYou may think you've got stress ...
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Take a Stress Test Claim Checkup
You know cardiovascular stress tests are common procedures, but you may find obtaining cor...
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Coding From the Doctor's Note:
Nix Nuclear Medicine Coding Mistakes Once and for All
You must have this documentation to report 78478, 78480Are you reporting all the nuclear m...
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Zero In on These Exercise Stress Test Descriptions
Here's why cardiologists use adenosine for MI patientsWhat it is: Cardiologists perform ca...
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Maximize Mod 59 Payment by Following CPT 2008 Guidelines
Ask, 'Did intervention occur on different coronary artery?'If you're still treating modifi...
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Reader Questions:
Decipher Private-Payer Mystery Edits
Question: I follow Correct Coding Initiative edits, but some insurers don't follow these g...
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Reader Questions:
Report CVP Line Separately From Left Heart Cath
Question: A physician placed a central venous pressure (CVP) line in one of the jugular ve...
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Reader Questions:
You Can Rely on Signs and Symptoms
Question: My doctor often uses a diagnosis of evaluation of left ventricle (LV) function o...
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Reader Questions:
Highlight ICE Catheterizations
Question: What are the CPT codes for patent foramen ovale (PFO) and atrial septal defect (...
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Reader Questions:
Attach Modifier 53 to Failed LV Lead Attempt
Question: If my cardiologist attempts to place an LV lead and fails, should I report this?...
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You Be the Coder:
Master MI's Fifth Digit With This Advice
Question: I'm confused about the fifth digits I should apply to myocardial infarction (MI)...
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Cardiology Coding Alert - 2008; Volume 11, Number 4
CCI Update:
3 Cardiology Coding Lessons Version 14.0 Can Teach You
Easy edit targets mean you must continue to be careful pairing these codes with other serv...
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Version 14.0 Update:
Make These Cardio Code Edits Part of Your Routine
Watch for what CCI says about reporting cardiac MRI codes togetherCCI version 14.0, effect...
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Coding From the Op Note:
Take These Right Heart Cath Essentials to Heart
Learn why you need to make the diagnostic-vs.-monitoring distinctionIf coding right heart ...
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You Be the Expert:
ABPM Readings
Question: Our cardiologist recently performed an ambulatory blood pressure monitoring on a...
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Reader Questions:
Strike QR and Use Q0 Instead
Question: A coding colleague of mine said that we're supposed to use the new Q0 modifier...
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Reader Questions:
Pinpoint the Organic Sleep Apnea ICD-9 Code
Question: What is organic sleep apnea? My physician has been using 780.57 to report sleep ...
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Reader Questions:
Solve This Same-Day Echo, Nuclear Study Scenario
Question: One of our cardiologists wants to do an echocardiogram on the same day as a nucl...
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Reader Questions:
Cath Coding Boils Down to Crossing the Heart
Question: Documentation from the cardiologist's op report states that he performed a heart...
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Cardiology Coding Alert - 2008; Volume 11, Number 3
CPT 2008 Update:
Prepare for Drastic Reimbursement Cuts, Thanks to Modifier 51 Exemption Reassessment
Experts warn that illogical reduction to this EP procedure means a loss of $171 Modifier ...
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Clip-and-Save Bonus:
Do These Top-10 Denials Look Familiar? Check Your List
Good news: The most common rejection reasons are also some of the easiest to prevent. If ...
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Think You Can Get Away with 414.00 for CAD? Think Again
Discover why you can report more than 1 CAD code for the patient If your cardiologist see...
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3 Tips Clarify Your Top HPI, Chronic Conditions Questions
Hint: You may find overlap between 1995 and 1997 guidelines You've asked questions...
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You Be the Expert:
Recall Frequency of Visits Still Up in the Air
Question: A patient came in to see our electrophysiologist to discuss the recall of Medtr...
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Reader Questions:
Avoid Partial Units of Adenosine
Question: If we have a 90-mg vial of Adenosine and use only 30 mg on the Medicare patient...
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Reader Questions:
Verify V Codes With Reason for Surgery
Question: Is there a specific diagnosis code for pre-op surgical clearance, or should I s...
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Reader Questions:
Exclude ICD Testing From Global
Question: I use 93641 for electrophysiologic (EP) testing of ICD leads/generator at the t...
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Reader Questions:
Consider These Specific Quit-Smoking Codes
Question: Sometimes we fret over the difficulty of getting paid for the numerous nonphysi...
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Cardiology Coding Alert - 2008; Volume 11, Number 2
CPT 2008 Update:
De-Stress Your Holidays by Getting Ready for These 5 New Cardiac Changes Now
Good news: You've got a new code for declotting with a thrombolytic agent It's official:...
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CPT 2008 Update:
Prepare Your Front Lines for 64-Lead EKG Cat III Codes
Hint: Using them now is a step toward permanent codes If you've been struggling to find t...
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CPT 2008 Update:
Tap Into Phone, Online E/M Codes for Extra Payment
Here are the criteria you have to meet to use these codes Great news: For those cardiolog...
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Perfect Picking EPS Package Codes With 2 Quick Tips
Revealed: Induced arrhythmia can change your EPS code Don't let coding comprehensive intr...
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You Be the Expert:
Do Additional Views Merit 75774?
Question: When our physicians perform peripheral angiograms on the lower extremities and ...
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Reader Questions:
CMS Says No-Show Fee Is OK -- Sometimes
Question: Did Medicare change its billing policy for missed appointments? What does the p...
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Reader Questions:
Find Elevated Creatine Kinase Dx Here
Question: The cardiologist examined a patient whose only diagnosis was "elevated creatine...
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Reader Questions:
Report Interp Only for Cardiolite Test
Question: Our physician interpreted a cardiolite stress test done at the hospital. He did...
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Cardiology Coding Alert - 2008; Volume 11, Number 1
CCI 13.3 Update:
Apply These Angiography Additions -- and 1 Deletion -- to Perfect Your Cardio Claims
Look out: The ability to use a modifier to separate an edit doesn't always mean you shoul...
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Evade E/M Mishaps by Homing In on History Levels
Warning: Not all payers accept 'all other systems reviewed and negative' If you're squeak...
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CCI 13.3 Update:
Injection Edits Draw the Line Btw Radiology and Cardiology
Heads up: Pay particular attention to modifier indicator status To complete the Correct C...
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You Be the Expert:
New Policy Allows You to Bill Moderate Sedation
Question: Can we bill sedation codes 99144-99145 with peripheral atherectomies and stents...
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Practical PV Tips:
Boost Your Bottom Line by Correcting Documentation
Here’s what you need to have to ethically report the higher-valued code The thre...
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Reader Question:
Easiest for Physician to Sign Off on NP's Charges
Question: I have a cardiologist with a nurse practitioner (NP) working for him, and she w...
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Reader Question:
Break Down Hospital Stress Test
Question: A patient complains of chest pain (786.50) and palpitations (785.1). The cardio...
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Reader Question:
Divide to Conquer Prolonged Inpatient Service
Question: Medicare denies our claims for prolonged inpatient hospital services. We report...
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Reader Question:
Heart Failure Diagnosis Trumps Other Symptoms
Question: What are some signs and symptoms that a patient might have had heart failure? K...
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