Cardiology Coding Alert

Hint: Category III CPT^® codes are temporary codes.

CPT^® 2024 will become effective on Jan. 1, 2024. And you’ll want to make sure you are familiar with all of the new cardiology Category III options. Among your new choices, you’ll see both new codes and revisions related to pacemakers and wireless cardiac stimulators.

Take a look at all of the Category III changes you should take note of in 2024.

Consider New Options for Wireless Cardiac Stimulators

Next year, you will gain several new codes related to wireless cardiac stimulators. They include the following:

• 0861T (Removal of pulse generator for wireless cardiac stimulator for left ventricular pacing; both components (battery and transmitter))
• 0862T (Relocation of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; battery component only) and 0863T (… transmitter component only)

CPT^® also added the following new leadless pacemaker Category III codes:

• 0823T (Transcatheter insertion of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when performed)
• 0824T (Transcatheter removal of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography), when performed)
• 0825T (Transcatheter removal and replacement of permanent single-chamber leadless pacemaker, right atrial, including imaging guidance (eg, fluoroscopy, venous ultrasound, right atrial angiography and/or right ventriculography, femoral venography, cavography) and device evaluation (eg, interrogation or programming), when performed)

Don’t miss: As you can see, 0823T is for the transcatheter insertion of a permanent single-chamber leadless pacemaker, while 0824T is for the removal, and 0825T is for the removal and replacement.

Dial Into These Revised Wireless Cardiac Stimulator Codes

CPT^® has also revised some wireless cardiac stimulator codes for 2024.

For example, 0517T will change to: (Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; pulse generator both component(s) of pulse generator (battery and/or transmitter) only). Emphasis added.

Code 0518T will change to: (Removal of only pulse generator component(s) (battery and/or transmitter) of for wireless cardiac stimulator for left ventricular pacing; battery component only). Emphasis added.

Code 0519T will change to: (Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming; pulse generator both component(s) (battery and/or transmitter) Emphasis added.

Code 0520T will change to (Removal and replacement of pulse generator for wireless cardiac stimulator for left ventricular pacing; pulse generator battery component(s) only (battery and/ or transmitter), including placement of a new electrode).

“This wireless cardiac stimulator for left ventricular pacing in a newer technology that is performed instead of inserting the large epicardial lead for left ventricular pacing we’re used to seeing —+33225 (Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (List separately in addition to code for primary procedure),” says Robin Peterson, CPC, CPMA, manager of professional coding and compliance services, Pinnacle Enterprise Risk Consulting Services, LLC in Centennial, Colorado.

Say Good-Bye to Some Category III Codes

You will also lose some Category III codes next year. In 2024, you will no longer be able to report the following:

• 0501T (Noninvasive estimated coronary fractional flow reserve (FFR) derived from coronary computed tomography angiography data using computation fluid dynamics physiologic simulation software analysis of functional data to assess the severity of coronary artery disease; data preparation and transmission, analysis of fluid dynamics and simulated maximal coronary hyperemia, generation of estimated FFR model, with anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report)
• 0502T (… data preparation and transmission)
• 0503T (…analysis of fluid dynamics and simulated maximal coronary hyperemia, and generation of estimated FFR model)
• 0504T (… anatomical data review in comparison with estimated FFR model to reconcile discordant data, interpretation and report)
• +0715T (Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure))

“You would now report 75580 (Noninvasive estimate of coronary fractional flow reserve (FFR) derived from augmentative software analysis of the data set from a coronary computed tomography angiography, with interpretation and report by a physician or other qualified health care professional) instead of the category III code,” Peterson said.

Understand the Significance of Category III CPT^® Codes

Category III CPT^® codes are temporary codes the AMA has assigned to represent emerging technologies, services, procedures, and services. According to the AMA, the codes are “intended to be used for data collection to substantiate widespread usage or to provide documentation for the Food and Drug Administration (FDA) approval process.” These codes are published on the AMA website every six months following approval by the CPT^® Editorial Panel. Category III CPT^® codes may not adhere to one or more of the following Category I code requirements:

• Drugs and devices necessary to perform the service or procedure have received FDA approval or clearance when required;
• Service or procedure is performed by many physicians or qualified healthcare professionals across the United States;
• Procedure or service is performed consistently;
• Procedure or service is consistent with current medical practice; or
• Documentation of the procedure or service clinical efficacy meets the CPT^® code change application requirements;

“Data collected from Category III codes is crucial to establishing Category I codes,” says Kristen R. Taylor, CPC, CHC, CHIAP, associate partner of Pinnacle Enterprise Risk Consulting Services.

“With the release of the 2024 CPT^® updates, 30 codes were removed from Category III status, and 82 new codes were added,” Peterson says.