Compliance Question of the Week – Cardiology

Cardiology Question for the Week of July 10, 2017

We were wondering which CPT® code to use for a volumetric computerized tomography (CT) scan of the heart to confirm pacemaker device placement, using contrast. We perform these CT scans after the device implant to check for lead placement/positioning when there have been capture issues.

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Cardiology Question for the Week of June 26, 2017

I have a question concerning billing of the cardiac stress test. We perform the nuclear stress test in our nuclear medicine department. A cardiologist supervises the stress exam when the patient is on the treadmill. The cardiologist reads the ECG but not the nuclear images, and the nuclear medicine physicians read the nuclear images.

The nuclear medicine department bills CPT codes 78452, 93017 and A9500. Should the cardiologist be billing codes 93016 and 93018 for the supervision of the stress test and ECG read?

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Cardiology Question for the Week of May 22, 2017

When it is billed, does For LUMASON® (sulfur hexafluoride lipid-type A microsphere) for injectable suspension, for intravenous use or intravesical use need a separate diagnosis, or is it covered under the primary reason the echo was ordered? Previously (ICD- 9) we used 794.39 (abnormal result of other cardiovascular function study) to bill for any enhancer used during an echo. Should we still be doing this with the new ICD-10 code R94.39 (abnormal result of other cardiovascular function study)?

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Cardiology Question for the Week of May 15, 2017

If a patient is brought to the cardiac cath lab and only bypass grafts were visualized (for example, SVG [saphenous vein graft] to the right coronary artery [RCA], and SVG to the circumflex) with no native coronary arteries being injected or imaged, what is the appropriate CPT procedure code to charge?

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Cardiology Question for the Week of May 8, 2017

One of our cardiologists attempted to cannulate the right radial artery using ultrasound (US) guidance. He says the vessel was well-visualized, and the needle could be seen within the vessel, but there was no return of flow. After several attempts without success, he used the right femoral artery for the exam. Can we bill for the US guidance and the radial puncture?

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Cardiology Question for the Week of May 1, 2017

In the cardiology question of 4-17-17, the provider asked what codes would be assigned for explanting the dual-system permanent pacemaker and implanting and attaching two new leads to the existing pacemaker on the other side of the chest. You stated that codes 33222, 33235 and 33217 would be assigned, but these only cover the relocation of a skin pocket and the electrodes. Based on the question, is the whole pacemaker being removed, relocated, and then re-implanted with two new leads? If so wouldn’t you code 33233, 33235, and 33208?

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Cardiology Question for the Week of April 24, 2017

One of our cardiologists performed the following: a left heart cath w/ coronaries, then a selective left subclavian angiogram to see whether there was a stenosis in the subclavian, and then a selective left internal mammary artery (LIMA) looking at it for a possible grafting site. How would we code this?

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