Cardiology Coding Alert

Just because you don't code VADs now doesn't mean you won't in the future

Have you ever reported a HCPCS code for a VAD patient? If not, you're likely to start doing so soon.

CMS is preparing for a shift to home-care, out-of-hospital use of ventricular assist devices (VADs) by expanding the one HCPCS choice into more than 20 codes--and it's your responsibility to know them by Oct. 3.

"Cardiologists need to be aware from the standpoint of doing the follow-up on these patients once they're discharged from the hospital and back in the community," says Nicole Coustier, senior associate at Quorom Consulting in San Francisco. Clinical experience and data have led to the VAD use for longer and longer-term support. Now VADs are not only bridge-to-transplant devices but also destination therapies in their own right.

Previously, you would have used L9900 (Orthotic and prosthetic supply, accessory, and/or service component of another HCPCS L code) to report Heartmate and Thoratec PVAD and IVAD products' equipment and supplies. Beginning Oct. 3, you'll have the following codes to choose from:

Red flag: You shouldn't report the HCPCS code for the batteries more than once every six months or the other accessories more than once each year after the patient is discharged from the hospital, says Robin Bostic, vice president of reimbursement at Thoratec Corp. in Burlington, Mass. If your cardiologist must replace an item before its expiration, you should add modifier RP (Replacement and repair) to Q0480-Q0499 and Q0501-Q0504.

Note: E-mail me at suzannel@eliresearch.com for a PDF showing how to use these new codes on your existing UB-92 form.