Cardiology Coding Alert

Question: When a national coverage determination doesn't specify which codes to use, how do we know which particular codes apply?Nevada SubscriberAnswer: When a national coverage determination (NCD) doesn't list specific codes for use, your next step should be to check for a local coverage determination (LCD) or local payer policy.For example: Palmetto GBA offers a list titled "J1 A/B MAC Palmetto GBA Assigned ICD-9-CM Codes for National Coverage Determinations." It doesn't supply codes for all NCDs, but it's a good starting point for J1 providers. It features codes for items including:Ambulatory Blood Pressure MonitoringExternal Counterpulsation (ECP) Therapy for Severe AnginaHyperbaric Oxygen TherapyImplantable Automatic Defibrillators.Check the list, and you'll see, for instance, that covered codes for ECP include G0166 (External counterpulsation, per treatment session) accompanied by one of the following:413.0, Angina decubitus413.1, Prinzmetal angina413.9, Other and unspecified angina pectoris. You can reach the site by starting at the J1 home page: [...]