Radiology Coding Alert

37225 isn't 'open' only

If you've been wondering why your CPT manual's atherectomy index entry doesn't point out your percutaneous options, you've got a good eye.

The answer is simple. Everyone makes mistakes. The AMA noted the problem and has published that and several other corrections to its CPT 2011 manual.

Checking the AMA errata for such corrections is very important, says Denae M. Merrill, CPC, HCC coding specialist in Saginaw, Mich. Take the time to mark the following changes in your manual, or you'll risk reporting the wrong code or not meeting key requirements.

Watch Change to 93923 Upper + Lower Rule

Along with correcting several minor typos in the updated 93922-93923 (... bilateral noninvasive physiologic studies of upper or lower extremity arteries ...) definitions and guidelines, the AMA makes one correction you want to be sure you catch.

As published, the second parenthetical note under complete study code 93923 states: "When both the upper and lower extremities are evaluated in the same setting, 93922 may be reported twice adding modifier 59 to the second procedure."

Correction: The sentence should refer to 93923 rather than 93922. The AMA also inserts the word "by" before "adding."

Thus the corrected text reads as follows (bold added): "When both the upper and lower extremities are evaluated in the same setting, 93923 may be reported twice by adding modifier 59 to the second procedure."

Avoid Index Confusion for These Revascularization Codes

With all of the changes to revascularization coding, you don't need index mistakes adding to the puzzle.

As published, the Atherectomy entry reads:

Open

Femoral . . . . . . . . . . . . . . . 37225, 37227

Popliteal . . . . . . . . . . . . . . 37225, 37227

Tibioperoneal . . . . .. . . . . . 37233, 37235

Coronary . . . . . . . . . . . . . . 92995-92996

See Artery, Coronary

Femoral . . . . . . . . . . . . . . . 37225, 37227

Popliteal . . . . . . . . . . . . . . 37225, 37227

Tibioperoneal . . . . .. . . . . . 37233, 37235

Correction: In addition to deleting the last three entries (which simply repeat the first three under "Open"), the AMA replaces "Open" with "Open or Percutaneous." This significant correction lets you know that the codes are appropriate whether the procedure is open or percutaneous.

Correct Index Mistake for 77013, Too

You rely on your index to direct you to the proper code, so take the time to correct the index entry for:

Guidance

Visceral Tissue Ablation

The entry as published points you to 76362, which isn't a valid code. The code the entry should point you to is 77013 (Computed tomography guidance for, and monitoring of, parenchymal tissue ablation).

Smart move: Check the corrections throughout the year, especially for services that may see changes, Merrill suggests.

You can locate the 2011 errata at www.ama-assn.org/ama1/pub/upload/mm/362/cpt-2011-corrections.pdf.