Cardiology Coding Alert

CCI version 14.0, effective Jan. 1, offers up multiple nonmutually exclusive (or Column 1/Column 2) edits for new cardiology-specific codes -- and it's up to you to put them into practice. In other words, because CPT 2008 released a handful of new cardiology-related codes, you've got dozens of new edits to learn.

Example: In 2008, you have new operative tissue ablation codes (33257-33259) that represent epicardial procedures, not endocardiac procedures, which cardiothoracic surgeons perform. These new operative tissue ablation codes now include codes 33210 and 33211 for the insertion or replacement of temporary transvenous single or dual chamber pacemaker or electrodes, says Jim Collins, CPC-CARDIO, ACS-CA, CHCC, president of The Cardiology Coalition in Saratoga Springs, N.Y.

Check out these bundles for other new cardiology codes, such as those for:

• cardiac MRI codes 75557-75564 (Cardiac magnetic resonance imaging for morphology and function ...)

• thoracentesis codes 32421-32422 (Thoracentesis, puncture of pleural cavity for aspiration ...)

• cath code 32550 (Insertion of indwelling tunneled pleural catheter with cuff)

• tube thoracostomy code 32551 (Tube thoracostomy, includes water seal [e.g., for abscess, hemothorax, empyema], when performed [separate procedure])

• operative tissue ablation codes (33254-33259, 33265-33266)

• ascending aorta graft code 33864

• wireless physiologic sensor code +34806 (Transcatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological supervision and interpretation, instrument calibration, and collection of pressure data)

• bypass graft code 35523 (Bypass graft, with vein; brachial-ulnar or -radial)

• declotting by thrombolytic agent code 36593 (Declotting by thrombolytic agent of implanted vascular access device or catheter).

Note: The codes with an "*" signify edits with a modifier indicator of "0." For instance, you'll never report 75559 (... without contrast material; with stress imaging) on the same day as 75561 (... without contrast material[s], followed by contrast material [s] and further sequences).

Remember, "0" means you can't override the edit. But a "1" modifier indicator means you can override an edit with a modifier when appropriate, says Maggie M. Mac, CMM, CPC, CMSCS, CCP, ICCE, consulting manager for Pershing, Yoakley and Associates in Clearwater, Fla.