Cardiology Coding Alert
CPT and ICD-9 1999 Update
The 99 CPT manual has two new radiology codes for two new procedures that will affect cardiology billing and reimbursement.
1. 78494 (Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study plus ejection fraction, with our without quantitative processing.)
This new procedure allows better assessment of regional wall function of the heart because the view is three dimensional, says Kenneth A. McKusick, MD, FACR, FACNP, coding and reimbursement chair for the Society for Nuclear Medicine.
The older procedure was specified in code 78472, (Cardiac blood pool imaging is a two-dimensional planar view), he explains.
The new code stands alone and can not be used in addition to 78472, he adds. Even if you have done both a three dimensional view and the planar view, you can not code for the planar view.
2. 78496 (Cardiac blood pool imaging, gated equilibrium, single study at rest, with right ventricular ejection fraction by first pass technique.)
This procedure, he explains, is used for patients who need a special evaluation of the right ventricle function. For example, it might be used for someone who is under evaluation for left ventricular cardiac disease, but also has indications of pulmonary obstructive disease.
This new code is an add-on one which may only be used with 78472, he says. Unlike, 78494, the provider is paid the full amount for this procedure (78496) in addition to the primary procedure (78472).
ICD-9
Practices that include pediatric cardiology services need to be aware of 659.70, the reclassified diagnosis code description for fetal distress, says Amy Blum, RRA, medical classifications specialist, National Center for Health Statistics, Hyattville, MD.
Before there was a code for fetal distress (656.3), but under it were a large number of inclusions. Some represented serious conditions; others were transient or not so serious, she says.
The description was revised because the ICD-9 committee felt the term fetal distress actually represents metabolic acidemia, she says.
So if the fetus or newborn has transient bradycardia, dont use code 659.70 to describe it, she says.
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