CPT 2002 Changes Include New Brachytherapy, AngioJet Codes
Published on Thu Nov 01, 2001
The CPT Codes 2002 manual includes new cardiology codes, as well as code revisions that should eliminate long-standing billing problems. The manual includes four important cardiology changes:
New codes for brachytherapy and use of AngioJet.
Deletion of a balloon-pump code and introduction of a new code.
Electrophysiology (EP) study and other EP codes.
Two procedural modifiers.
The full effect of these changes on billing and reimbursement will not be known until CMS publishes its fee schedule in the Federal Register, to include relative values of all new and existing CPT codes.
New Brachytherapy Code
92974 transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (list separately in addition to code for primary procedure).
Restenosis, the recurrence of coronary artery blockage at the treatment site, often complicates the treatment of coronary artery disease with angioplasty or stents. Restenosis at the site of a prior stent placement occurs in 15 to 25 percent of patients who undergo coronary stent implantation during a percutaneous transluminal coronary angioplasty (PTCA).
Intracoronary brachytherapy, also known as coronary artery radiation treatment, is being used more and more to treat restenosis following an earlier intervention. The radiation is delivered via a special catheter that is passed into the coronary artery to the area of restenosis, explains Marko Yakovlevitch, MD, FACP, FACC, a cardiologist in Seattle.
While anticoagulants can prevent thrombosis (blood clotting) at the treatment site, they cannot prevent the tissue buildup associated with restenosis at the treatment site. Researchers have postulated for several years that small doses of radiation applied to the section of the coronary artery being treated might prevent the tissue growth associated with restenosis. The FDA approved two coronary artery radiation systems in November 2000, the Beta-Cath System (Novoste Corp.) and the Checkmate System (Cordis Corp.). The systems differ in that Beta-Cath uses beta radiation and emits electrons, whereas Checkmate uses gamma radiation and emits photons.
The treatment prevents restenosis by killing the cells that have reoccluded the stent and by inhibiting further tissue growth, Yakovlevitch says. The techniques require special equipment and trained individuals and have similar FDA-approved labeling that limits coverage of brachytherapy to treatment of in-stent restenosis in native coronary arteries.
Cardiologists who use brachytherapy have several reimbursement issues to consider. Until recently, the FDA had not approved the devices that are used to perform the service. Although the FDA has approved the treatments, carriers still may not cover the service for coronary interventions. And, the CPT manual did not include a brachytherapy code until now, so [...]
