Cardiology Coding Alert

Edits reveal how CMS expects you to use 2012 codes.

January 1 doesn't just mean the switch to new CPT codes. It also means the release of Correct Coding Initiative (CCI edits) that incorporate all those new codes.

This round of edits became effective Jan. 1, 2012, for physicians. The edits are intended for use by Medicare, but many private payers adopt them, too. "For version 18.0, 15,530 new edit pairs have been added to the database while 6,197 have been terminated," said Frank Cohen, principal and senior analyst for The Frank Cohen Group in his NCCI Change Analysis 18.0, available from www.frankcohengroup.com/Library/ResearchandStudies.aspx.

Deleted codes: Many of the 6,197 deleted edits reflect the fact that when a code is deleted, edits related to that code are no longer needed.

As an example, this version deleted 45 edits that had 75724 (Angiography, renal, bilateral, selective [including flush aortogram], radiological supervision and interpretation) in the column 2 position. CPT® 2012 deleted 75724, so the edits are no longer necessary.

New/revised codes: With the many changes to the pacemaker (PM) and implantable cardioverter-defibrillator (ICD) codes, you can rest assured that many of the 15,530 new edit pairs relate to those additions.

If you're used to bundling certain services into PM and ICD services, you can expect to see similar bundles for the new codes, too.

For example, CCI bundles cath codes like 36000 (Introduction of needle or intracatheter, vein) and ECG codes like 93000 (Electrocardiogram, routine ECG ...) into new code 33221 (Insertion of pacemaker pulse generator only; with existing multiple leads).

CCI edits also can help ensure you're applying CPT® guidelines.

For instance, the guidelines tell you that you may not report device evaluation codes 93279-93299 separately at the time of pulse generator or lead insertion, replacement, or upgrade, as noted in the Cardiology Services Update by Kenneth P. Brin, MD, PhD, FACC, of the CPT® Editorial Panel, and James Blankenship, MD, MACC, FSCAI, of the Relative Value Update Committee, at the CPT® and RBRVS 2012 Annual Symposium.

So under CCI version 18.0, you'll find 93279-93299 bundled into many of the new and revised device codes, such as 33221 and 33227-33229 (Removal of permanent pacemaker pulse generator with replacement of pacemaker pulse generator...).