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Cardiology Coding Alert

READER QUESTIONS:

Check CMS Manuals for G0166 Details

Published on Mon Oct 26, 2009

Question: I've heard that payment for ECP is decreasing in 2010. Where can I find more information on G0166? California Subscriber Answer: Check out the Medicare Claims Processing Manual, Chapter 32, Section 130, and the Medicare National Coverage Determinations Manual, Chapter 1, Section 20.20, for more information on G0166 (External counterpulsation, per treatment session). RVUs: The drop in relative value units (RVUs) isn't too substantial, changing from 4.16 in 2009 to 4.03 in 2010. ECP: The manuals explain that ECP is a non-invasive treatment for coronary artery disease. Medicare covers the service for patients with stable angina if the cardiologist decides they aren't good surgery candidates. CMS has a specific list of reasons patients aren't amenable to surgery, such as having an inoperable condition or risk-creating comorbidities. You'll find a long list of codes you shouldn't report alongside G0166 unless you can prove they were separate and distinct. These include [...]
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