Cardiology Coding Alert

Hint: Observe these four new interrogation and programing evaluation codes.

In Cardiology Coding Alert Vol. 21, No. 10, you learned about the CPT^® 2019 updates you should prepare for including cardiac rhythm monitor additions, new transcatheter codes, and peripherally inserted central venous catheters (PICC) codes changes.

Now, take a look at the Category III deletions and additions for cardiology to also be aware of. Category III codes (also known as “T-codes”) are temporary codes for emerging services.

Don’t miss: “Practitioners, coders and billers must be educated and updated regarding the CPT^® and HCPCS coding changes to help ensure codes are being submitted accurately for compliance purposes and proper reimbursement is received,” says Cynthia A. Swanson, RN, CPC, CEMC, CHC, CPMA, senior manager of healthcare consulting for Seim Johnson in Omaha, Nebraska.

Additionally, any related internal policies/procedures outlining coding/billing of services and related medical record documentation should be reviewed at a minimum, on an annual basis to incorporate the new changes, Swanson adds.  

Investigate These Cardiac Stimulator Additions

Per CPT^® 2019, you will have several new options for reporting cardiac stimulator services.

Insertion: For the insertion of a wireless cardiac stimulator, you can look to 0515T (Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and interpretation, when performed; complete system (includes electrode and generator [transmitter and battery])).

Removal: You will also get the two new removal codes for wireless cardiac stimulators:

• 0519T (Removal and replacement of wireless cardiac stimulator for left ventricular pacing; pulse generator component(s) (battery and/or transmitter))
• 0520T (… pulse generator component(s) (battery and/or transmitter), including placement of a new electrode).

Don’t miss: Along with the above new removal codes, you will also have a new option 0518T when the cardiologist removed just the pulse generator component, the battery and/or transmitter for a left ventricular pacing cardiac stimulator.

Example: The cardiologist removed and replaced the battery for a wireless cardiac stimulator for left ventricular pacing for a patient. You would report 0519T.

Highlight New Interrogation and Programing Evaluation Codes

Additions: CPT^® 2019 will also offer four new interrogation and programming device evaluation codes. For wireless cardiac stimulators you will have new interrogation device evaluation codes 0521T and programming device evaluation code 0522T.

Then, for intracardiac ischemia monitoring systems, you will have new interrogation code 0529T and new programming device evaluation code 0528T.

Check Out Intracardiac Ischemia Monitoring System Insertion, Replacement, and Removal Codes

For intracardiac ischemia monitoring systems, CPT^® 2019 will give you several new options. Check out the following codes for insertion or replacement of intracardiac ischemia monitoring systems.

• 0525T (Insertion or replacement of intracardiac ischemia monitoring system, including testing of the lead and monitor, initial system programming, and imaging supervision and interpretation; complete system (electrode and implantable monitor))
• 0526T (…; electrode only)
• 0527T (…; implantable monitor only).

Removal: And for removal of intracardiac ischemia monitoring systems, take a look at the following three new codes:

• 0530T (Removal of intracardiac ischemia monitoring system, including all imaging supervision and interpretation; complete system (electrode and implantable monitor))
• 0531T (…; electrode only)
• 0532T (…; implantable monitor only).

Observe Numerous Miscellaneous Additions

You should also make sure you note these miscellaneous T cardio codes:

• 0541T (Myocardial imaging by magnetocardi­ography (MCG) for detection of cardiac ischemia, by signal acquisition using minimum 36 channel grid, generation of magnetic-field time-series images, quantitative analysis of magnetic dipoles, machine learning-derived clinical scoring, and automated report generation, single study)
• 0542T (…; interpretation and report)
• 0523T (Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure))
• 0524T (Endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, open or percutaneous, including all vascular access, catheter manipulation, diagnostic imaging, imaging guidance and monitoring).

Example: For example, if the cardiologist performs an open endovenous catheter directed chemical ablation with balloon isolation of incompetent extremity vein, you would report 0524T.

Don’t miss: According to the code descriptor, this code applies for both open or percutaneous endovenous catheter directed chemical ablation.