Cardiology Coding: Changes You Need to Know for 2017!

1. Cardiology Coding: Cardiology Coding: Changes You Need to Know for 2017 You Need to Know for 2017! ! Presented By: Presented By: Rachel M. Kaser, BS, CPC, MHSA Rachel M. Kaser, BS, CPC, MHSA AHIMA AHIMA- -Approved ICD Approved ICD- -10 Auditor; SuperCoder.com Auditor; SuperCoder.com Changes 10- -CM/PCS CM/PCS Trainer Trainer

2. Course Objectives 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 2

3. Transluminal Angioplasty (Peripheral) 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 3

4. Transluminal Angioplasty (Peripheral) 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 4

5. Transluminal Angioplasty (Peripheral) 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 5

6. Paravalvular Leak Closure 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 6

7. Left Atrial Appendage Closure Left Atrial Appendage Closure (LAAC) (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 7

8. Mechanochemical (MOCA) Vein Ablation 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 8

9. Coronary Thrombectomy 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 9

10. ICD ICD- -10 10- -CM Updates: Cardiology 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 10

11. ICD ICD- -10 10- -CM Updates: Cardiology 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 11