Cardiology Coding: Changes You Need to Know for 2017!

Presented By:

Rachel M. Kaser, BS, CPC, MHSA AHIMA-Approved ICD-10-CM/PCS Trainer

Auditor; SuperCoder.com

Course Objectives

• Become familiar on reporting transluminal angioplasty codes and where bundling is applied

• Find out the meaning behind EKG’s in order to accurately complete coding

• Understand changes to the ICD-10-CM coding guidelines

• Learn about the new codes set forth for hypertensive crisis and hypertensive emergency

• Obtain knowledge about the new codes for renal and visceral angioplasty

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Transluminal Angioplasty (Peripheral)

• Reorganized, recorded, relocated for 2017

• 35450-35476 are deleted within CPT

• CPT refers you to codes 36902, 36905, 36907 and 37246, 37247, 37249

• Note: CPT instructs you to report both selective and non-selective catheterization separately

• Intravascular ultrasound and mechanical thrombectomy along with thrombolytic therapy may also be reported separately

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Transluminal Angioplasty (Peripheral)

• 36902, 36905, 36907: Part of a new series of codes for diagnostic catheterization and intervention for dialysis circuits (36901-36909)

• Includes all imaging guidance, supervision and interpretation

• If coding for non-dialysis, i.e., renal or visceral arteries, see codes 37246-37249

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Transluminal Angioplasty (Peripheral)

• 37246-37247 are for ANGIOPLASTY within the arteries

• 37248-37249 are for venous angioplasty

• All codes are reporting open and percutaneous angioplasty

• All codes include the imaging and radiological supervision necessary to perform the procedures

• Additional radiology codes 75791, 75962, 75964, 75968, 75970 have been deleted from the 2017 CPT manual

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Paravalvular Leak Closure

• Billable codes now available for Paravalvular leak closures

• 93590: Percutaneous closure of Paravalvular leaks for the mitral valve

• 93591: Percutaneous closure of Paravalvular leaks for the aortic valve

• Codes report INITIAL occlusion device only

• +93592: Each additional device

• INCLUDES fluoroscopic imaging guidance, angiography and radiological imaging services

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Left Atrial Appendage Closure (LAAC) • New CPT code includes the imaging

• Category I code 33340

• Ensure you do not bill separately for the radiological supervision and interpretation

• Do not report a diagnostic heart catheterization separately with this procedure unless distinctly documented per CPT guidelines

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Mechanochemical (MOCA) Vein Ablation

• Codes 36473-36474 have been added for Mechanochemical (MOCA) Vein Ablation

• Code choice is now distinct based on the type of ablation method utilized (i.e., TECHNIQUE)

• Imaging guidance and monitoring are all inclusive with these new codes

• Ensure add on codes 36474, 36476, 36479 are only reported once per extremity

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Coronary Thrombectomy

• Add on code: 92973

• Mechanical thrombectomy (i.e., Angiojet procedure) is separately reportable with a coronary intervention

• Non-mechanical “aspiration” thrombectomy should NOT be reported with this code

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ICD-10-CM Updates: Cardiology

• R73.03: Prediabetes

• Common symptoms documented within the encounter:

• High blood pressure

• HDL cholesterol is below 35 milligrams per deciliter

• Triglyceride level is above 250 mg/dL

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ICD-10-CM Updates: Cardiology

• Diagnosis: Paroxysmal Atrial Fibrillation

• I48.0: Paroxysmal Atrial Fibrillation

• Sequenced first when it is the primary reason for the encounter as determined within the Assessment and Plan

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