Cardiology Coding Alert

To complete the Correct Coding Initiative (CCI) picture, you'll need to tap into these heart catheterization injection edits and put them into coding practice.

One series of edits bundles pulmonary injections (75741-75746) into common heart catheterization services (93501-93514, 93524-93533).

Rationale: "Basically, this prevents coders from combining two sets of codes not designed to be used in combination (meaning one set CPT designed for radiologists, the other cardiologists)," says Jim Collins, CPC-CARDIO, ACS-CA, CHCC, president of The Cardiology Coalition in Saratoga Springs, N.Y. All of these edits have a modifier indicator of "0," which means you should never report them together under any circumstance.

The next series of edits bundles radiological studies (typically performed at a time other than during a heart catheterization) with heart cath-specific contrast injection codes.

The heart cath specific injection codes are:

• 93539 -- Injection procedure during cardiac catheterization; for selective opacification of arterial conduits, whether native or used for bypass

• 93541 -- ... for pulmonary angiography

• 93544 -- ... for aortography.

93539: You won't report 93539 when your cardiologist performs 75756 (Angiography, internal mammary, radiological supervision and interpretation). This edit carries a modifier indicator of "0," which means that you won't be able to report these codes together under any circumstance.

93541: Second, when you report 75741, 75743, or 75746, you should consider 93541 included. This edit carries a modifier indicator of "1," which means you can apply a modifier as long as you have supporting documentation.

93544: This code is now a component to aortography codes 75600, 75605, 75625, and 75630, and computed tomographic angiography code 75635 (Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, radiological supervision and interpretation, without contrast material[s], followed by contrast material[s] and further sections, including image post-processing). All of these edits allow you to bypass them with a modifier, but this should be a last-case scenario, not the norm.