Cardiology Coding Alert

If you've been struggling to find the codes that reflect electrocardiograms with 64 or more leads or chest x-ray computer-aided detection (CAD) services, there's good news on the horizon. The American Medical Association includes these category III codes in the CPT 2008 book.

EKGs with 64 or more leads receive three new category III codes.

Important: You'll still use 93000-93010 for a routine EKG with at least 12 leads. But for an EKG with 64 or more leads, you should use 0178T-0180T, which took effect in July 2007 and will appear in the 2008 CPT book.

Break down: New code 0178T (Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; with interpretation and report) covers an EKG with graphics and analysis and interpretation and report.

You'll use 0179T (... without interpretation and report) for tracing and graphics only, and 0180T (... interpretation and report only) for interpretation and report only.

Back on Jan. 1, 2007, two new category III codes took effect for chest x-ray CAD, in response to provider requests, says Michael Longacre, HealthCare Market Strategies Inc. consultant in Yamhill, Ore.:

These codes are not in the CPT 2007 manual, but you'll find them in CPT 2008.

Use 0174T with the originating chest x-ray CPT code, Longacre says. But 0175T "is a stand-alone code that is not inclusive of the chest x-ray." So when that chest x-ray CAD is performed at a different time, location or by another physician than the original chest x-ray, use 0175T, he says.