Cardiology Coding Alert

Look out: The ability to use a modifier to separate an edit doesn't always mean you should Oct. 1 brought adjustments to the way you report angiography codes alongside codes for various cardiology procedures, thanks to Correct Coding Initiative (CCI) version 13.3. Discover how you should apply these edits, as well as codes for electrophysiology during operative ablation services, and your claims will sail through every time. First, Review CCI Rules Medicare applies CCI edits to services reported by the same provider for the same beneficiary on the same date of service, says Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, director of outreach programs for the American Academy of Professional Coders based in Salt Lake City. Each CCI code-pair edit includes a correct coding modifier indicator of 0 or 1. A "0" indicator means that you may not unbundle the edit combination under any circumstances, according to CCI guidelines. An indicator of "1" means that you may use a modifier to override the edit if the procedures are distinct from one another (for instance, if they occur in separate anatomic locations).- Delete This Diagnostic Angio Edit Good news: You've got some relief from a diagnostic angiography edit deletion. Rationale: When you look at the CPT instructions specific to 37215 (Transcatheter placement of intravascular stent[s], cervical carotid artery, percutaneous; with distal embolic protection), you'll see that you should include any diagnostic angiogram of the target vessel performed at the same time as a carotid stent as part of the stent placement service itself, says Jim Collins, CPC-CARDIO, ACS-CA, CHCC, president of The Cardiology Coalition in Saratoga Springs, N.Y. CCI 13.3 deleted the edit binding 75650 (Angiography, cervicocerebral, catheter, including vessel origin, radiological supervision and interpretation) to 37215 because the original intention was more specific to aortic arch angiography, not carotid angiography. In other words, when your cardiologist performs 37215 (the stent placement) and includes any diagnostic imaging of the vessel involved, but not of the aortic arch (75650), you should report that service separately. Since CCI repealed this edit, you do not need to attach any CCI-recognized modifier, Collins says. Edits Take Aim on 3 Angiography Codes However, you have a slew of angiography edits to take into account. Modifier allowed: You should amend the way that you report 75600 (Aortography, thoracic, without serialography, radiological supervision and interpretation) and 75605 (Aortography, thoracic, by serialography, radiological supervision and interpretation). These codes are now components of codes 93501, 93503, 93505, 93508, 93510, 93511, 93514, 93524-93533, and 93556. The edits carry a modifier indicator of "1," meaning that you may separate them with a modifier when you have supporting documentation. For example, the doctor may need to conduct a thoracic aortogram (75600) at [...]