Part B Insider (Multispecialty) Coding Alert

Keep an eye out: CPT 2009 may contain new combined echocardiography code

A provision in the 2008 Physician Fee Schedule proposal could snuff out your reimbursement for color flow Doppler (CPT code 93325).

The proposal: The Centers for Medicare & Medicaid Services (CMS) wants to bundle 93325 into all of the other echocardiogram base codes. This will have a significant impact on echocardiography providers, as well as patient care and safety, wrote Ariel Soffer, a physician with the Holly-wood, FL-based Florida Institute for Cardiovascular Care in his comments on the proposed regulation.

-It is imperative that CMS understand the additional practice expense and physician work involved in the performance and interpretation of color flow studies,- said Soffer. He was one of dozens of physicians who wrote to CMS to protest this provision before the Aug. 31 deadline.

-In conjunction with two-dimensional echocardiography, color Doppler typically is used for identifying cardiac malfunction,- said a form letter which some other physicians sent to CMS. -In particular, color Doppler information is critical to the decision-making process in patients with suspicion of valvular disease and appropriate selection of patients for valve surgery.-

The CPT Editorial Panel has recommended a new CPT code for 2009, which would combine 93325 and echocardiography code 93307, wrote cardiologist Paul Kim. But the Panel didn't consider bundling 93325 into 14 other codes, as CMS wants to. CMS should wait for the new code, and not bundle 93225 into these other codes without consulting physicians, Kim insisted.

If CMS does bundle 93325 into any codes, the only reasonable candidates are 93320-93321, which are also Doppler codes, noted Cheryl Schneider with North Ohio Heart Center.

-From a business perspective, this represents an impressive decrease in income at a time when our costs of doing business are only increasing,- wrote Kent Dauterman with The Heart Clinic in Medford, OR.

In other comments, physicians wrote to protest the 9.9 percent cut scheduled for January.

Commenters also supported a change to geographic practice expense categories that would boost some undervalued regions. Also, Consumer Union, which publishes Consumer Reports magazine, wrote to support the Physician Quality Reporting Initiative and other quality measures.