Cardiology Coding Alert

The CPT update season is fast approaching. Warm up for the changes coming your way with a look at new-for-2010 Category III codes aimed at diagnosing coronary artery disease.

One of the new Category III codes with a Jan. 1 implementation date is 0206T (Algorithmic analysis, remote, of electrocardiographic-derived data with computer probability assessment, including report), which is appropriate for Premier Heart's Multifunction CardioGram (MCG).

The service: The MCG uses a mathematical approach to diagnose heart disease,states Joseph Shen, MD, founder and co-developer of the MCG technology, in a press release. Practices using the technology provide an in-office test similar to a resting ECG and then send the information to an MCG datacenter for analysis, which includes scoring the cardiac disease severity and listing differential diagnoses.

Catch this: The MCG system uses two leads. You may report a 12-lead ECG separately when performed, according to a note with the code. Choose from 93000- 93010 (Electrocardiogram, routine ECG with at least 12 leads...).

For 2010, CPT also adds +0205T (Intravascular catheter-based coronary vessel or graft spectroscopy [e.g., infrared] during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation, and report, each vessel [List separately in addition to code for primary procedure]). This code describes a relatively new technology, such as InfraReDx, which physicians may use to identify lipid or cholesterol deposits in the vessel wall.

Don't miss: Code +0205T is an add-on code -- meaning you may not report it alone. A note instructs you to report it alongside the following codes, as appropriate:

• 92980 -- Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel

• 92982 -- Percutaneous transluminal coronary balloon angioplasty; single vessel

 • 92995 -- Percutaneous transluminal coronary atherectomy, by mechanical or other method, with or without balloon angioplasty; single vessel

• 93508-93533 -- cardiac catheterization.

Keep in mind: Category III codes describe emerging technologies, so a typical practice might not use the devices these new codes describe, says Sandy Fuller,CPC, MCS-P, HIS supervisor and compliance officer for Cardiovascular Associates of East Texas.

But you need to keep track of available Category III codes. CPT guidelines state that if CPT offers a Category III code for a particular service, you must report that code instead of a Category I unlisted code.

So if your cardiologist returns from a conference eager to start using a new device, go to the manufacturer's Web site and familiarize yourself with it, says Fuller. "Then check the CPT and Category III codes on the AMA site to see if something seems to fit," she says. To be sure you're using the most appropriate choice, consider the manufacturer's coding recommendation, and also research information available from the AMA and payers for their preferences.

Benefit: When you have a Category III option, not only is using it accurate, but you'll also be helping to determine whether the service will get a permanent code. "Medicare uses Category III codes for tracking purposes, and based on the tracking information, CPT may or may not eventually introduce a Category I code for them," explains Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CENTC, CHCC, president of N.J.-based CRN Healthcare Solutions.

Resource: You can download a list of the new codes from the AMAWeb site (www.ama-assn.org). Under Physician Resources, choose "Solutions for Managing Your Practice." In the menu on the left, choose "Coding Billing Insurance," then "CPT," and finally "About CPT" to reach the page where you may download Category III codes.