Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery. It involves the extraction of clots from occluded coronary arteries and deployment of stents and balloons through a small hole made in a major artery.
With the introduction of new cardiology coding update, coding for interventional cardiovascular services has undergone considerable changes that have made coding and billing for the services performed complex and confusing. This year cardiologists will be working with complex codes that are better designed to describe the procedures and the intensive care offered to patients, but payment for services will hit an all time low.
13 new codes have been approved by the AMA to report percutaneous coronary interventions including base codes for angioplasty, atherectomy, and stenting. Also included are specific set of codes for percutaneous transluminal revascularization for acute total or subtotal occlusion when codes 92941 or 92943 is used.
Usually when a cardiac intervention is performed in the main vessel along with an additional branch, a single code is used to report it. But with the new codes, only a base code is required to report the procedure along with an add-on code for each additional branch of a major coronary artery. The changes will benefit cardiologists as they will be able to reflect their work more effectively and secure deserved valuation and reimbursement for the complicated and time-consuming procedures that they perform.
But there are doubts regarding the use of these new codes. As per the final rule of 2013 Medicare Physician Fee Schedule issued on Nov. 1, it has been said that physicians would not be paid for add-on codes. According to officials, the reason for rejecting the add-on codes is because of the fear that this can encourage physicians to increase the placement of stents unnecessarily.
According to officials at SCAI are still considering the Medicare fee schedule rule to determine whether physicians can report add- on CPT codes although they won’t be paid by Medicare.
There are financial implications as well. Although the decision of the CMS comes as a surprise, it will help to lessen the financial impact on physicians as payment for base codes has been increased by Medicare when the decision was taken that payment will not be made for add-on codes.
According to experts, no matter which method is followed, physicians will experience considerable cut in payment for interventional cardiology services.
The new codes are 92920, 92921, 92924, 92925, 92928, 92929, 92933, 92934, 92937, 92938, 92941, 92943 and 92944 which have replaced CPT code 92980-92984, 92995, and 92996.