Cardiology Coding Alert

Question: How should we report external counterpulsation (ECP)? Are practices still performing this service?

North Dakota Subscriber

Answer: Most Medicare carriers instruct you to use G0166 (External counterpulsation, per treatment session). This code is limited to 35 sessions in a twelve-month period. For private payers, you might have luck with 92971 (Cardioassist method of circulatory assist; external).

What happens: During an ECP treatment, the patient is placed on a table and his lower trunk and extremities are wrapped in a series of three compressive air cuffs. The cuffs inflate and deflate in synchronization with the patient's cardiac cycle. As a result, most patients are said to experience increased time until onset of ischemia, increased exercise tolerance and a reduction in the number and severity of anginal episodes.

Insurers consider this procedure medically necessary for patients with chronic angina (413.9).

Note: This service still exists, but many coders report having trouble finding patients willing to drive to their cardiology practice five days a week for 35 sessions.