Cardiology Coding Alert

You'll cheer for new anticoagulant codes--here's why CPT 2007 brings many major changes to cardiology coding, and you're responsible for learning how to use this slew of new codes by Jan. 1. As with last year, you've got no grace period.

"No matter how hard you prepare, it always feels like a rip-tide effect -- the old codes being yanked out from underneath you, while trying to keep up with the new codes for the new year," says Karen Salowitz, RN, CPC, billing coordinator at Heart and Vascular Center of Arizona in Phoenix.

Avoid feeling this way by learning the following cardiology changes now. Pacemaker Insertion Gets Overhaul When you prepare to report pacemaker insertions with epicardial electrode(s), you've got to strike out two old codes and look to two new ones to represent the service your cardiologist provided.

In the past: When your cardiologist inserted a pacemaker with epicardial electrode(s), you would report either 33200 (Insertion of permanent pacemaker with epicardial electrode[s]; by thoracotomy) or 33201 (... by xiphoid approach).

As of Jan. 1: CPT 2007 introduces 33202 (Insertion of epicardial electrode[s]; open incision [e.g., thoracotomy, median sternotomy, subxiphoid approach]) and 33203 (... endoscopic approach [e.g., thoracoscopy, pericardioscopy]) for insertion of an epicardial electrode(s). Notice how one code covers open incision and the other covers endoscopic approach.

Important: You can use 33202 and 33203 for either pacemakers or defibrillators. The new parenthetical note under 33240 says, "Use 33240, as appropriate, in addition to the epicardial lead placement codes to report the insertion of the generator when done by the same physician during the same session." You should use these new codes for the electrode placement, not the generator.

"The fact that cardiologists can perform this endoscopically is great news for patients," says Inga Burton, CPC, certified coding specialist at Pima Heart Physicians in Tucson, Ariz. "This minimally invasive approach can offer a safe and effective option for patients whose vascular anatomy prevents a percutaneous approach to cardiac resynchronization therapy."

New codes 33202-33203 are also great news for coders. "Because the incision and endoscopic approaches are distinct, and CPT codes are supposed to describe exactly what the cardiologist performs, this is a positive change for 2007," says Rhena Burge, billing analyst for North Oaks Medical Center in Hammond, La.

Don't miss: In addition, CPT 2007 deletes 33245 (Insertion of epicardial single or dual chamber pacing cardioverter-defibrillator) and 33246 (... with insertion of pulse generator). CPT Clarification Solves Your CTA Questions Chest computed tomographic angiography (CTA) code 71275 (Computed tomographic angiography, chest [noncoronary], without contrast material[s], followed by contrast material[s] and further sections, including image postprocessing) now clarifies that it only applies to noncoronary chest CTAs. In other words, you should use this specifically for the CT of [...]