Cardiology Coding Alert

Remember: Category III codes (also known as “T-codes”) are temporary codes for emerging services.

When CPT^® 2020 becomes effective on Jan. 1., you’ll want to stay updated on the new cardiology T-codes and deletions. Among your new choices, you’ll see new codes related to implantable defibrillator-pacing electrodes and new interrogation device evaluation codes for implantable cardioverter-defibrillator systems.

Read on to learn more.

Discover New Transcatheter Tricuspid Valve Repair T-Code Options

CPT^® 2020 will bring numerous new T-codes you must learn in your cardiology practice. For transcatheter tricuspid valve repair, you’ll get the following two codes:

• 0569T (Transcatheter tricuspid valve repair, percutaneous approach; initial prosthesis)
• 0570T (… each additional prosthesis during same session (List separately in addition to code for primary procedure)).

Category III codes defined: Category III codes (also known as “T-codes”) are temporary codes for emerging services.

From a billing standpoint, keep in mind that Category III codes often apply to services that payers consider investigational/experimental. “This means you may not get reimbursed for the procedure,” says Jim Pawloski, BS, MSA, CIRCC, R.T. (R)(CV), interventional radiology technologist/coder at William Beaumont Hospital in Royal Oak, Michigan, and coder at Adreima in Phoenix, Arizona.

Catch New Implantable Defibrillator-Pacing Electrode Codes

Additions: You’ll also get the following new codes dealing with implantable defibrillator-pacing electrodes:

• 0572T (Insertion of substernal implantable defibrillator electrode). Report this code if the cardiologist inserts a substernal implantable defibrillator electrode.
• 0573T (Removal of substernal implantable defibrillator electrode). Report this code if the cardiologist removes a substernal implantable defibrillator electrode.
• 0574T (Repositioning of previously implanted substernal implantable defibrillator-pacing electrode). Report this code if the cardiologist repositions a previously implanted implantable defibrillator electrode.

Caution: As you can see, all of the above codes specify that the implanted defibrillator electrode must be substernal.

Dial Into New Programming and Interrogation Device Codes

Additions: In 2020, you’ll also gain a new programming device evaluation T-code and a new interrogation device evaluation T-code for implantable cardioverter-defibrillator systems:

• 0575T (Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional)
• 0576T (Interrogation device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter).

Additions: And, catch these two interrogation device evaluations for substernal lead implantable cardioverter-defibrillator systems:

• 0578T (Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional)
• 0579T (Interrogation device evaluation(s) (remote), up to 90 days, substernal lead implantable cardioverter-defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results).

Mark Down T-Code Deletions

Deletions: CPT^® 2020 will delete 0254T (Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma, dissection) using bifurcated endograft from the common iliac artery into both the external and internal iliac artery, including all selective and/or nonselective catheterization(s) required for device placement and all associated radiological supervision and interpretation, unilateral).

Instead of 0254T, you should report new endovascular repair of the iliac artery codes 34717 and 34718. Report 34717 when the endovascular repair of the iliac artery is associated with the aorto-iliac artery endograft placement by deployment of an iliac branched endograft.

On the other hand, you should report 34718 when the endovascular repair of the iliac artery is not associated with the placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft.

Deletions: Also, CPT^® 2020 will delete +0399T (Myocardial strain imaging (quantitative assessment of myocardial mechanics using image-based analysis of local myocardial dynamics) (List separately in addition to code for primary procedure)). When January 1 rolls around, you should report new code 93356 (Myocardial strain imaging using speckle tracking-derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging)) instead.