CPT coding of cardiac catheterizations is quite easy. There are a limited set of codes that are to be used. Let us first understand what is done during cardiac catheterization.
The physician accesses the femoral artery and passes the catheter with/without gudewire to reach the aorta and may/maynot perform aorogram. Then the cathter is reached to LCA ostium and coronary angiography is performed. The physican then performs ventriculogram. For angiographies first contrast injections are performed followed by radiologic imaging. The physician also takes reading various heart readings for which no codes are requied.
CPT coding of cardiac catheterization involves codes for cardiac catheterizations, injections and angiograms i.e. radiologic supervision and interpretation.
Get your cath code first—it will most frequently be either of the following:
Right heart catheterization (93501 which will start from the femoral vein)
(37.21) (88.52)
Left heart catheterization (93510 which will start from the femoral artery)
(37.22) (88.53)
Combined left and right heart catheterization (93526 which will include the femoral artery and vein)
(37.23) (88.54)
CPT codes for cardiac injection (93539-93545)
There are specific codes for bypass arteries or native main arteries (e.g. mammary)
(93539 don’t append modifier-51)
(88.55 or 88.56)
bypass veins (93540 don’t append modifier-51),
(88.55 or 88.56)
native arteries and veins; also called coronary angiography (93545
don’t append modifier-51)
(88.55 or 88.56)
as well as aortography (93544
don’t append modifier-51 ) for the aorta
(88.42)
and heart chambers: the ventricles and atria; also called ventricular or atrial
angiography (93542; 93543 append modifier-51 )
(88.52, 88.53, or 88.56)
- then your S&I codes (93555-93556
don’t append modifier-51
)
(included in 88.52-88.56)
93555 goes with 93542 and 93543 only representing the heart chambers
93556 goes with all the other injection codes.
For ICD-9-CM coding of the injection and imaging portion of the cardiac cath:
First of all, note that procedures classified to 89.6x are not coded with cardiac
cath
You use only 88.55 or 88.56 for all coronary vessel imaging—there is no
distinction made between the different types of coronary vessels and bygrafts. In most
cases, a two catheters are referenced (88.56), but if only one catheter is referenced, you
would use 88.55.
For the heart chambers, you use one code for the right heart structures in a right
heart cath (88.52), one code for the left heart structures in a left heart cath (88.53), and
one code for combined heart structures in a combined heart cath (88.55).
Common Cardio Abbreviations:
LIMA: left internal mammary artery
OM: obtuse marginal artery
ICA: intercranial/internal carotid artery
ECA: extracranial/external carotid artery
CCA: common carotid artery
SVC: superior vena cava
IVC: inferior vena cava
Don’t forget modifiers to identify coronary arteries and recall that any branches of
these arteries are not recognized for separate CPT code reporting:
LC—left circumflex coronary artery
RC—right coronary artery
LD—left anterior descending artery
Final Tips:
Note: a left heart cath must include the catheter passing the aortic valve into the left heart
chambers, otherwise code 93508 should be used. You must also note the approach when
considering your initial cath codes: there are several others types of left heart caths codes
and combined types of cath codes such as retrograde by cutdown (93511) for a left heart
cath and left ventricular puncture for a left heart cath (93514) and for a combined heart
cath (93528).
If contrast is used, be sure that it is captured via chargemaster or otherwise—this is
separately reimbursed. Codes most likely will be Q9949 or Q9950 based on the specified
type of material. Be sure to report the proper number of units used. Other supplies are
Coding Cystoscopy and Transurethral Procedures
CPT codes for cystoscopy, cystoureteroscopy and cystouretheroscopy codes are in 52000-52700 range.
CPT code 52353 cystoureteroscopy with lithotripsy involves fragmentation of ureteral calculus with a grapser and also includes removal of calculus (CPT 52352). CPT code 52325 should be used when fragmentation of ureteral calculus is done using ultrasonic or hydrolic technique (ESWL).
CPT code 52332 is used for placement of permanent indwelling stent like Double J. Cystoscopic placement or removal of a temporary ureteral catheter (52005) is included in 52320-52355.
CPT code 52353 cystoureteroscopy with lithotripsy involves fragmentation of ureteral calculus with a grapser and also includes removal of calculus (CPT 52352). CPT code 52325 should be used when fragmentation of ureteral calculus is done using ultrasonic or hydrolic technique (ESWL).
CPT code 52332 is used for placement of permanent indwelling stent like Double J. Cystoscopic placement or removal of a temporary ureteral catheter (52005) is included in 52320-52355.
CPT Coding Knee Arthroscopy
CPT codes 29866-29887 are used to report knee arthroscopy procedures.
HCPCS code G0289, Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee, is also used in some instances for Medicare claims.
Considering that only one compartment of knee is involved, we see what codes can be coded and what are bundled together
CPT code 29875 limited synovectomy and or plica resection is bundled into CPT chondroplasty and CPT menisectomy codes 29877 and 29880. Hence if plica resection, which is part of synovium, and chondroplasy are performed in the same compartment at the same session, only chondroplasty should be reported. Similarly if limited synovectomy and menisectomy is done in the same compartment, only menisectomy code 29880-29881 should be reported.
Most of the the time synovectoy is performed for better visualization during arthroscopy as it obstructs the view of the physician and hence shoud not be coded as it is included in the procedure being done.
Major synovectomy is an extensive procedure and includes condroplasty.
Abrasion chondroplasty includes chondroplasy. Abrasion chondroplasty involves microfractures or drilling to the bone till bleeding for better regeneration.
Femoral notchplasty if performed alone is coded to 29999 unlisted arthroscopic code. Femoral notchplasty is included in chondroplasty so if chondroplasty is peformed it should not be reported seperately.
Femoral notchplasty is also included in anterior cruciate ligament reconstruction hence should not be coded seperately when ACL is performed.
CPT code for arthroscopic loose body removal should be coded only if no other procedure is performed in the same compartment of the knee. For loose bodies greater than 1 CM a seperate code can be used.
Use CPT code 29873 for Arthroscopic lateral release for patellar dislocations.
Knee Compartments:
From CPT coding prospective there are three knee compartments patellofemoral, medial, and lateral. Medical femoral condyle and lateral femoral condyle are part of medical and lateral compartments respectively.
HCPCS code G0289, Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee, is also used in some instances for Medicare claims.
Considering that only one compartment of knee is involved, we see what codes can be coded and what are bundled together
CPT code 29875 limited synovectomy and or plica resection is bundled into CPT chondroplasty and CPT menisectomy codes 29877 and 29880. Hence if plica resection, which is part of synovium, and chondroplasy are performed in the same compartment at the same session, only chondroplasty should be reported. Similarly if limited synovectomy and menisectomy is done in the same compartment, only menisectomy code 29880-29881 should be reported.
Most of the the time synovectoy is performed for better visualization during arthroscopy as it obstructs the view of the physician and hence shoud not be coded as it is included in the procedure being done.
Major synovectomy is an extensive procedure and includes condroplasty.
Abrasion chondroplasty includes chondroplasy. Abrasion chondroplasty involves microfractures or drilling to the bone till bleeding for better regeneration.
Femoral notchplasty if performed alone is coded to 29999 unlisted arthroscopic code. Femoral notchplasty is included in chondroplasty so if chondroplasty is peformed it should not be reported seperately.
Femoral notchplasty is also included in anterior cruciate ligament reconstruction hence should not be coded seperately when ACL is performed.
CPT code for arthroscopic loose body removal should be coded only if no other procedure is performed in the same compartment of the knee. For loose bodies greater than 1 CM a seperate code can be used.
Use CPT code 29873 for Arthroscopic lateral release for patellar dislocations.
Knee Compartments:
From CPT coding prospective there are three knee compartments patellofemoral, medial, and lateral. Medical femoral condyle and lateral femoral condyle are part of medical and lateral compartments respectively.
Coding Arthroscopy Shoulder Procedures
CPT codes for shoulder arthroscopy requires good understanding of shoulder anatomy.
Arthroscopic coracoplasty (partial resection of the coracoid process’s posterolateral side) is not included in 29826. Report 29999.
CPT does not have a code for arthroscopic posterior remplissage, so report 29999 (Unlisted procedure, arthroscopy).
CPT code 29828 Arthroscopic biceps tenodesis does not include the arthroscopic bicep tenotomy. Report 29999 (Unlisted procedure, arthroscopy)
SLAP lesion is a superior labrum lesion not inferor labrum. Repair of a torn labrum should not be coded to 29807 because 29807 represents repair of SLAP tear and all labral tears are not SLAP tears. According to AAOS report 29806 with 29807 only if the SLAP lesion repair is Type 2 or Type 4. For the other 5 types of SLAP lesions, it may not be appropriate to report 29807 with 29806.
Repair (debridement) of a type I SLAP lesion is always coded as 29822 (Arthroscopic debridement, limited). Repairs of types II and IV SLAP lesions are coded 29807 (Repair SLAP lesion) because an actual repair is performed.
Type III SLAP lesions are bucket-handle tears and can be either debrided or repaired; use 29822 or 29807, whichever is appropriate. Adding code 29806 (Arthroscopy, shoulder, surgical, capsulorrhaphy) for repair of a SLAP lesion is never appropriate unless there is a capsular defect in an area different than the SLAP. This is one of the most common coding errors. Even if a staple or other device goes through the capsule to repair the SLAP, capsulorrhaphy should not be coded separately.
A partial synovectomy (29820) or limited debridement (29822) would consist of work done in just a portion of the shoulder, such as the front or the back of the shoulder. To support a complete synovectomy (29821) or extensive debridement (29823), the documentation should support work in BOTH the front and back of the shoulder.
CPT code for arthroscopic distal clavicle resection includes extensive debridement.
Arthroscopic coracoplasty (partial resection of the coracoid process’s posterolateral side) is not included in 29826. Report 29999.
CPT does not have a code for arthroscopic posterior remplissage, so report 29999 (Unlisted procedure, arthroscopy).
CPT code 29828 Arthroscopic biceps tenodesis does not include the arthroscopic bicep tenotomy. Report 29999 (Unlisted procedure, arthroscopy)
SLAP lesion is a superior labrum lesion not inferor labrum. Repair of a torn labrum should not be coded to 29807 because 29807 represents repair of SLAP tear and all labral tears are not SLAP tears. According to AAOS report 29806 with 29807 only if the SLAP lesion repair is Type 2 or Type 4. For the other 5 types of SLAP lesions, it may not be appropriate to report 29807 with 29806.
Repair (debridement) of a type I SLAP lesion is always coded as 29822 (Arthroscopic debridement, limited). Repairs of types II and IV SLAP lesions are coded 29807 (Repair SLAP lesion) because an actual repair is performed.
Type III SLAP lesions are bucket-handle tears and can be either debrided or repaired; use 29822 or 29807, whichever is appropriate. Adding code 29806 (Arthroscopy, shoulder, surgical, capsulorrhaphy) for repair of a SLAP lesion is never appropriate unless there is a capsular defect in an area different than the SLAP. This is one of the most common coding errors. Even if a staple or other device goes through the capsule to repair the SLAP, capsulorrhaphy should not be coded separately.
A partial synovectomy (29820) or limited debridement (29822) would consist of work done in just a portion of the shoulder, such as the front or the back of the shoulder. To support a complete synovectomy (29821) or extensive debridement (29823), the documentation should support work in BOTH the front and back of the shoulder.
CPT code for arthroscopic distal clavicle resection includes extensive debridement.
HCPCS Codes
What are HCPCS codes?
HCPCS stands for the Healthcare Common Procedure Coding System. HCPCS codes can are divided into two sets of codes. The first, or Level I, code set is a five-digit numeric code that contains the Physician's Current Procedural Terminology (CPT) maintained by the American Medical Association. The CPT is comprised of descriptive terms and identifying codes used primarily for billing for services provided by physicians and other healthcare professionals. The second code set, or Level II, is a code set for medical services not included in Level I, such as durable medical equipment, prosthetics, orthotics and supplies. These codes are alpha-numeric in that they begin with a single letter, such as an A or D in the case of durable medical equipment, followed by four numbers.
HCPCS codes were developed to simplify medical billing. There are a number of items with HCPCS codes that Medicare categorically does not cover. Whether an item with a HCPCS code is covered under a particular state Medicaid program depends on whether the item meets the state=s definition of durable medical equipment, prosthetics, orthotics, or any other service covered in that state.
HCPCS codes can be found (although not easily) on the CMS website, http://www.cms.hhs.gov/home/medicare.asp. Under coding, click on AHCPCS Release and Code Sets.@ Then click on AAlpha-Numeric HCPCS@ on the left. Click on the A2008 Alpha-Numeric HCPCS File@ and download the ZIP file.
cpt hcpcs code, hcpcs code, hcpc code,
HCPCS stands for the Healthcare Common Procedure Coding System. HCPCS codes can are divided into two sets of codes. The first, or Level I, code set is a five-digit numeric code that contains the Physician's Current Procedural Terminology (CPT) maintained by the American Medical Association. The CPT is comprised of descriptive terms and identifying codes used primarily for billing for services provided by physicians and other healthcare professionals. The second code set, or Level II, is a code set for medical services not included in Level I, such as durable medical equipment, prosthetics, orthotics and supplies. These codes are alpha-numeric in that they begin with a single letter, such as an A or D in the case of durable medical equipment, followed by four numbers.
HCPCS codes were developed to simplify medical billing. There are a number of items with HCPCS codes that Medicare categorically does not cover. Whether an item with a HCPCS code is covered under a particular state Medicaid program depends on whether the item meets the state=s definition of durable medical equipment, prosthetics, orthotics, or any other service covered in that state.
HCPCS codes can be found (although not easily) on the CMS website, http://www.cms.hhs.gov/home/medicare.asp. Under coding, click on AHCPCS Release and Code Sets.@ Then click on AAlpha-Numeric HCPCS@ on the left. Click on the A2008 Alpha-Numeric HCPCS File@ and download the ZIP file.
cpt hcpcs code, hcpcs code, hcpc code,
Medical Coding Colleges
Medical Coding Colleges
CNI College Coding School in Orange County
The California State University, East Bay offers Certificate in Medical Billing and Coding
MTI College's healthcare school offers medical billing and coding program at MTI College california.
Kaplan College Riverside, offers California Medical Billing and Coding Programs
Brighton College is accredited by the Accrediting Commission of the Distance Education and Training Council (DETC), Washington D.C.
Anthem Education Group medical coding and billig diploma at following locations
Anthem College - Aurora, Beaverton, Kansas City, Milwaukee, Minneapolis, Cherry Hill, Jersey City, Las Vegas, New York, North Brunswick, Parsippany, Springfield, Memphis, Nashville, Orlando, Sacramento, Dallas
Sanford-Brown colleges offering medical coding are located at Atlanta GA, Middleburg Heights OH, Collinsville IL, Cranston RI, Dallas TX, Dearborn MI, Farmington CT,Fenton MO, Fort Lauderdale FL, Garden City NY, Grand Rapids MI, Hazelwood MO, Houston TX, Iselin NJ, Indianapolis IN, Jacksonville FL, Landover MD, Milwaukee WI, Monroeville PA, New York NY, North Loop TX, Phoenix AZ, San Antonio TX, St. Peters MO, Tampa FL, Tinley Park IL, Trevose PA, White Plains NY, Vienna VA
Mandl School in New York City.
The Academy of Health Care Professions offers medical coding programmes in Texas
Remington College's Medical Billing and Coding Program is available at the following campuses: Baton Rouge, Cleveland, Cleveland West, Colorado Springs(1), Dallas, Ft. Worth, Houston, Houston Southeast, North Houston, Lafayette, Little Rock, Memphis, Mobile, Nashville and Shreveport.
Westwood College Dallas - Dallas, Fort Worth, Houston South
CNI College Coding School in Orange County
The California State University, East Bay offers Certificate in Medical Billing and Coding
MTI College's healthcare school offers medical billing and coding program at MTI College california.
Kaplan College Riverside, offers California Medical Billing and Coding Programs
Brighton College is accredited by the Accrediting Commission of the Distance Education and Training Council (DETC), Washington D.C.
Anthem Education Group medical coding and billig diploma at following locations
Anthem College - Aurora, Beaverton, Kansas City, Milwaukee, Minneapolis, Cherry Hill, Jersey City, Las Vegas, New York, North Brunswick, Parsippany, Springfield, Memphis, Nashville, Orlando, Sacramento, Dallas
Sanford-Brown colleges offering medical coding are located at Atlanta GA, Middleburg Heights OH, Collinsville IL, Cranston RI, Dallas TX, Dearborn MI, Farmington CT,Fenton MO, Fort Lauderdale FL, Garden City NY, Grand Rapids MI, Hazelwood MO, Houston TX, Iselin NJ, Indianapolis IN, Jacksonville FL, Landover MD, Milwaukee WI, Monroeville PA, New York NY, North Loop TX, Phoenix AZ, San Antonio TX, St. Peters MO, Tampa FL, Tinley Park IL, Trevose PA, White Plains NY, Vienna VA
Mandl School in New York City.
The Academy of Health Care Professions offers medical coding programmes in Texas
Remington College's Medical Billing and Coding Program is available at the following campuses: Baton Rouge, Cleveland, Cleveland West, Colorado Springs(1), Dallas, Ft. Worth, Houston, Houston Southeast, North Houston, Lafayette, Little Rock, Memphis, Mobile, Nashville and Shreveport.
Westwood College Dallas - Dallas, Fort Worth, Houston South
Healthcare Coding
Healthcare coding also known as medical coding is encription of medical records data using universally recognized coding languages such as ICD, CPT, HCPCS. The purpose of healthcare coding in US is primarily for reimbursement of healthcare insurance claims. In healthcare coding, the medical records are scanned by a coding specialist and all the diagnosis, procedures, medical history, adverse effects are assigned ICD, CPT, or HCPCS codes thus each code represents a particular disease, procedure, or surgical intervention. Insurance companies pay claims according to the codes that are associated with a claim.
Healthcare coding industry can be said as recession proof industry because even during recession there was good demand for healthcare coding specialists. The future prospects of healthcare coding is also bright as the healthcare overhaul in the United States guarantees continue increased demand for healthcare coding professionals.
Healthcare coding industry can be said to be last to be effected by outsourcing as hospitals are still reluctant to outsoource coding work. This is because a single wrong code can result in a significant loss of revenue for the hospitals. So the hospitals want the coders to work in hospital itself, so as and when if they get any dought regarding coding, they could clarify it with the physicians right away.
Healthcare coding industry can be said as recession proof industry because even during recession there was good demand for healthcare coding specialists. The future prospects of healthcare coding is also bright as the healthcare overhaul in the United States guarantees continue increased demand for healthcare coding professionals.
Healthcare coding industry can be said to be last to be effected by outsourcing as hospitals are still reluctant to outsoource coding work. This is because a single wrong code can result in a significant loss of revenue for the hospitals. So the hospitals want the coders to work in hospital itself, so as and when if they get any dought regarding coding, they could clarify it with the physicians right away.
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