Cardiology Coding: Changes You Need to Know for 2017!

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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
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Course Objectives

• Become familiar on reporting transluminal
  angioplasty codes and where bundling is applied
• Find out the meaning behind EKGs 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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