Cardiology Coding Alert

Remember: Category III codes have an expiration date.

Although you won’t gain any new cardiology-related Category I CPT^® codes next year, you will see a plethora of Category III cardiology options, including electrocardiogram and cardiac contractility modulation-defibrillator system codes.

Learn everything you need to know to appropriately report Category III codes next year.

Know About New Electrocardiogram Options

Next year, you will see many new Category III codes related to electrocardiograms. For example, you will gain 0903T (Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; with interpretation and report) through 0905T (… interpretation and report only).

You will also be able to report several new external electrocardiographic codes, including 0937T (External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation by a physician or other qualified health care professional) through 0940T (… review and interpretation by a physician or other qualified health care professional).

Finally, 2025 brings you 0897T (Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded clinical parameters, including uploading clinical parameters with interpretation and report), which involves a 12-lead electrocardiogram, per the descriptor.

Understand Multitude of Cardiac Contractility Modulation- Defibrillation System Options

Next year also brings many new codes for cardiac contractility modulation (CCM).

Insertion: For CCM insertion, you will gain 0915T (Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse generator and dual transvenous electrodes/ leads (pacing and defibrillation)) through 0918T (… dual transvenous leads (pacing and defibrillation) only).

Removal: For CCM removal, report 0919T (Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only) through 0922T (… dual (pacing and defibrillation) transvenous leads only).

For removal and replacement, report 0923T (Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only).

Repositioning: For CCM repositioning, report 0924T (Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic parameters).

Relocation: For CCM relocation, report 0925T (Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator).

Programming/Interrogation Device Evaluation: For CCM programming report 0926T (Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including review and report, implantable cardiac contractility modulation-defibrillation system).

For CCM interrogation device evaluation, report the following:

• 0927T (Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-defibrillation system)
• 0928T (Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care professional)
• 0929T (… remote data acquisition(s), receipt of transmissions, technician review, technical support, and distribution of results)

Don’t miss: CCM is a heart failure treatment that uses a device to help your heart pump blood. This therapy gives your heart the boost it needs to function better and alleviate heart failure symptoms like breathlessness, fatigue, confusion, and swelling in the legs.

Navigate Category III Codes With Ease

CPT^® lists “temporary” codes with four numerals followed by “T” in the Category III section. These temporary codes have been assigned by the AMA to represent emerging technologies, services, procedures, and service paradigms. These codes are published on the AMA website every six months following approval by the CPT® Editorial Panel.

The purpose of Category III codes is to allow data collection regarding how often clinicians perform a particular service. That means you should not use an unlisted Category I code if CPT^® provides a Category III code for a procedure — the latter takes priority, according to the section guidelines

Note: Category III codes have an expiration date, which is typically after five years. Before expiration, the AMA either converts the procedure to a Category I code or archives the code due to limited use.

Payment: The Centers for Medicare & Medicaid Services (CMS) does not assign Relative Value Units (RVUs) to Category III codes. That means there is no established fee schedule for the codes. Individual payers will establish coverage and payment for these codes.

Important: Regardless of current pay, you should report Category III codes if you perform the described services. “Reporting the Category III codes provides the data for clinical

usage that could impact conversion to a Category I code and future payment,” says Terri Brame Joy, MBA, CPC, COC, CGSC, CPC-I, revenue cycle director for Clinical Health Network for Transformation in Houston, Texas.