Reader Question:
Include Carotid Massage in E/M Service
Published on Wed Mar 28, 2007
Question: I've looked in CPT for a code for carotid massage, but our physician says the code descriptions I found don't match the service he provided. Is there a CPT code specifically for carotid massage?
New Hampshire Subscriber
Answer: You should count carotid massage as part of the E/M service. A cardiologist may perform carotid sinus massage in the office on patients who do not have carotid bruits (785.9, Other symptoms involving cardiovascular system), have had recent myocardial infarction (410.x, Acute myocardial infarction) or recent stroke (438.2x, Hemiplegia/hemiparesis), or have a history of ventricular tachycardia.
By pressing the carotid sinus, the cardiologist induces slowing of the heart rate. But he must be cautious when applying such pressure to elderly patients because there is a risk of dislodging carotid plaque, which could lead to cerebral atheroemboli (445.89) and a stroke.
You Be the Coder and Reader Questions were prepared with the assistance of Jim Collins, ACS-CA, CHCC, CPC, CEO of the Cardiology Coalition and compliance manager for several cardiology groups around the country; and reviewed by Jerome Williams Jr., MD, FACC, a cardiologist with Mid Carolina Cardiology in Charlotte, N.C.
