Cardiology Coding Alert

Hint: T codes are also called Category III Codes.

When Jan. 1, 2021 rolls around and CPT^® 2021 becomes effective on Jan. 1., you’ll want to make sure you are familiar with all of the new cardiology T-codes and deletions. Among your new choices, you’ll see new codes related to automated quantification and characterization of coronary atherosclerotic plaque and percutaneous transcatheter implantation of an interatrial septal shunt device.

Read on to learn more.

Take a Look at New Automated Quantification Coronary Atherosclerotic Options

In 2021, you will gain the following four new codes relating to the automated quantification and characterization of coronary atherosclerotic plaque:

• 0623T (Automated quantification and characterization of coronary atherosclerotic plaque to assess severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and transmission, computerized analysis of data, with review of computerized analysis output to reconcile discordant data, interpretation and report)
• 0624T (… data preparation and transmission)
• 0625T (… computerized analysis of data from coronary computed tomographic angiography)
• 0626T (… review of computerized analysis output to reconcile discordant data, interpretation and report)

Don’t miss: Cardiologists perform 0623T-0626T services to help assess the severity of a patient’s coronary disease.

Dig Into New Percutaneous Transcatheter Implantation Codes

Next year, you will also see a new code for the percutaneous transcatheter implantation of an interatrial septal shunt device: 0613T (Percutaneous transcatheter implantation of interatrial septal shunt device, including right and left heart catheterization, intracardiac echocardiography, and imaging guidance by the proceduralist, when performed).

Additionally, when your cardiologist performs the removal and replacement of a substernal implantable defibrillator pulse generator, you can turn to new code 0614T (Removal and replacement of substernal implantable defibrillator pulse generator).

Also, you will gain a new code for endovascular venous arterialization: 0620T (Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed).

“Endovascular venous arterialization is a non-surgical procedure for “end stage” critical limb ischemia and essentially creates an arteriovenous fistula to help direct blood flow to the deep veins of the extremity in patients that most often do not have any other options of treatment,” says Robin Peterson, CPC, CPMA, Manager of Professional Coding, Pinnacle Integrated Coding Solutions, LLC.

Finally, if your cardiologist performs a percutaneous transcatheter ultrasound ablation, you will have new code 0632T (Percutaneous transcatheter ultrasound ablation of nerves innervating the pulmonary arteries, including right heart catheterization, pulmonary artery angiography, and all imaging guidance).

T code refresher: You’ll find the T-codes section toward the back of your CPT^® book. T-codes, also called Category III Codes, are “temporary codes for emerging technology, services, procedures, and service paradigms. Category III codes allow for the collection of specific data,” according to CPT^®. Payment for these codes is not guaranteed, and you’ll need to work out the details with your payers before reporting any T-codes so you’ll know if the service is covered.

Check Out Numerous T-Code Deletions and 1 Revision

You will lose several cardiology T-codes in 2021 including 0085T (Breath test for heart transplant rejection) and 0126T (Common carotid intima-media thickness (IMT) study for evaluation of atherosclerotic burden or coronary heart disease risk factor assessment).

You will also lose numerous electrocardiographic (ECG) recording T codes including 0295T (External electrocardiographic recording for more than 48 hours up to 21 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review and interpretation)-0298T (… review and interpretation).

Additionally, you will lose ECG recording codes 0381T (External heart rate and 3-axis accelerometer data recording up to 14 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; includes report, scanning analysis with report, review and interpretation by a physician or other qualified health care professional)-0386T (External heart rate and 3-axis accelerometer data recording more than 30 days to assess changes in heart rate and to monitor motion analysis for the purposes of diagnosing nocturnal epilepsy seizure events; review and interpretation only).

Revision: You will only see one revised cardiology T-code in 2021. (Emphasis added): 0577T (Electrophysiological evaluation of implantable cardioverter-defibrillator system with substernal electrode (includes defibrillation threshold evaluation, induction of arrhythmia, evaluation of sensing for arrhythmia termination, and programming or reprogramming of sensing or therapeutic parameters)). This revision is so minor that you might miss it if you blink, but “electrophysiological evaluation” will change to “electrophysiologic evaluation” in the code’s descriptor.