Cardiology Coding Alert

The latest edition of the national Correct Coding Initiative (CCI) edits version 9.0, effective Jan. 1 to March 1 could bring changes to the way you code intraoperative ultrasonic guidance when used with transesophageal echocardiography (TEE).

The American College of Cardiology (ACC) has advised Medicare carriers that intraoperative ultrasonic guidance should not be bundled with codes for TEE (93312-93318) because physicians use ultrasonic guidance primarily to direct biopsies.

Cardiologists use TEE to diagnose cardiac sources of emboli, prosthetic heart valves, endocarditis, aortic dissection, cardiac tumors, vascular heart disease and congenital heart diseases, says Martha Gerant, CPC, professional coder and reimbursement specialist for Cardiology Services in Olathe, Kan. According to the ACC, the CCI edits will "allow CCI-associated modifiers to be used if 76986 (Ultrasonic guidance, intraoperative) is used for a purpose unrelated to TEE, resulting in payment for both procedures." You should review the latest CCI changes for both additions, which can mean revenue limitations, and deletions, which may indicate revenue opportunities. You can order a copy of the CCI edits from the National Technical Information Service by calling (800) 363-2068. Note: Look for more on the CCI edits in the February issue of Cardiology Coding Alert.