Cardiology Coding Alert

See which diagnosis codes are likely to pair with these new procedure codes.

Minimally invasive procedures are becoming more accepted for heart procedures all the time. CPT^® 2014 gets in line with clinical practice by adding new codes for percutaneous patent ductus arteriosus closure and percutaneous septal reduction.

PDA closure: CPT^® 2014 added 93582 (Percutaneous transcatheter closure of patent ductus arteriosus) to represent closing a patent ductus arteriosus (PDA) by a percutaneous approach. This addition may prove useful for many cardiology coders, notes Christina Neighbors, MA, CPC, CCC, ACS-CA, a cardiology coding expert in Tacoma, Wash. Closure typically involves maneuvering an occluding device through the vascular system to the heart. Moderate sedation is included in this code. You also should not separately report congenital right or left heart catheterization, aorta or pulmonary artery catheter placement, or aortic arch angiography because 93582 includes those services.

The ductus arteriosus is a blood vessel needed before birth to move blood around the fetus’s lungs. Once the baby is born, the ductus arteriosus isn’t needed and typically closes within a few days. The term patent means open, so the term PDA indicates that the patient’s ductus arteriosus didn’t close. The result is abnormal blood flow between the pulmonary artery and aorta. The appropriate ICD-9-CM code for PDA is 747.0. The ICD-10-CM code is Q25.0.

Septal reduction: Another percutaneous cardiac surgery code added for 2014 is 93583 (Percutaneous transcatheter septal reduction therapy [e.g., alcohol septal ablation] including temporary pacemaker insertion when performed).

You may see this procedure for patients with hypertrophic obstructive cardiomyopathy (ICD-9-CM: 425.11; ICD-10-CM: I42.1). The treatment reduces an area of abnormally thick heart muscle between the ventricles that’s causing an obstruction.

The code definition states the code includes temporary pacemaker insertion when performed. Physicians often will insert a temporary pacemaker because atrioventricular block can be a complication of the procedure. Left heart catheterization and moderate sedation are also included in this code.

Coming soon: These codes have plenty of guidelines accompanying them, so stay tuned for a comprehensive look into reporting these codes properly.