Cardiology Coding Alert

Caution: The CPT® guidelines may not be where you expect them.

To help in the 2013 transition from old non-coronary thrombolysis codes to new, you may want to jot a few notes in your CPT^® resource.

Crosswalk: First, you may find it helpful "to write the old code(s), in parentheses, next to the new code," says Julie Graham, BA, CPC, cardiology coder and compliance specialist for Concentra in Texas. This technique helps with the "mental transition in understanding the new codes, as well as ensuring that I don’t overlook their respective revisions or use outdated codes," says Graham. 

As an example, whether you use a manual or software, you can make a note with codes 37211 and 37212 as a reminder that you used to use 37201, 75896, and 75898 for the same services.

Guidelines: If you use a manual, you also may want to make a note next to the codes that there are important guidelines before 37184. Key points include:

Intraprocedural thrombolytic injections aren’t reportable with mechanical thrombectomy, but 37211-37214 are appropriate for "subsequent or prior continuous infusion of a thrombolytic"

For bilateral thrombolytic infusion through separate access sites, append modifier 50 (Bilateral procedure) to 37211 or 37212

Report only 37211 or 37212 if the physician begins and completes thrombolysis on the same date (don’t report 37214)

Catheter placement(s), diagnostic studies, and other percutaneous interventions may be separately reportable

Related E/M services on the same date are included in thrombolysis, but separately identifiable E/M services are reportable with modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service)

Ultrasound guidance for vascular access is separately reportable using +76937 (Ultrasound guidance for vascular access requiring ultrasound evaluation of potential access sites, documentation of selected vessel patency, concurrent realtime ultrasound visualization of vascular needle entry, with permanent recording and reporting [List separately in addition to code for primary procedure]), assuming code requirements are met.