CPT 2006 Update:
Modify Your Thrombectomy and Consult Coding Habits Before Jan. 1
Published on Wed Nov 23, 2005
Hint: You'll need to pay more attention to your 2-D reconstruction CT scan documentation
You've got only a short time before you'll have to implement CPT's 2006 changes on Jan. 1--especially since there's no grace period--so here are the five major changes likely to affect your cardiology practice that you should learn now. 1. Good News for Thrombectomy Procedures Right now, you can bill for mechanical thrombectomy only if the physician performs it in a coronary vessel or arteriovenous fistula. But starting in January, you'll be able to bill for mechanical thrombectomy in peripheral vessels as well.
Break it down: New codes cover primary mechanical thrombectomy for noncoronary, arterial or arterial bypass graft for the initial vessel (37184) and each additional vessel (37185). Another new code covers secondary thrombectomy (37186). And a third covers percutaneous mechanical transluminal thrombectomy, including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance (37187) and a repeat treatment on a subsequent day (37188).
"These new thrombectomy codes are wonderful. We've added a new physician who specializes in peripheral vascular disease, so this is a biggie for us," says Jennifer Kelchen, MA, CCS-P, manager of the coding department for Cardiologists P.C. in Cedar Rapids, Iowa. "There's nothing worse than having to use the dreaded 37999 (Unlisted procedure, vascular surgery) code--it just delays your payments and creates a lot of extra paperwork."
2. Central Line Patency Check Gets CPT's Attention If you've been billing for a central venous access device assessment, known as a central line patency check, your troubles may be over.
The new way: Until now, you've had to bill for this procedure using an unlisted code plus a fluoroscopy code, says Cheryl Schad, BA Ed, CPC, ACS-RA, owner of Schad Medical Management in Mullica Hill, N.J. But now CPT 2006 will add a new code for this procedure (36598, Contrast injection[s] for radiologic evaluation of existing central venous access device, including fluoroscopy, image documentation and report). "We might actually see some reimbursement for this procedure," Schad predicts.
You'll use 36598 when your physician injects contrast to see if there's a problem with a venous access device (such as fibrin around the ends) or a change in position, says Jackie Miller, RHIA, CPC, senior consultant at Coding Strategies in Dallas, Ga. The cardiologist checks to see if the contrast is able to pass through the device to determine if it continues to provide access. 3. 76375 Becomes Two New Codes Those of you who have been billing 76375 for two-dimensional reconstructions of CT scans, MRIs or other imaging scans, will have to change your ways starting in January.
CPT 2006 deletes 76375 and replaces it with two new codes. Important: Both new codes specify that the rendering must be 3D, unlike 76375, which [...]
