Compliance Question of the Week – Cardiology

For Medicare hospital billing, if a planned PTCA is attempted but the balloon cannot be advanced across the lesion, can we bill for the attempted angioplasty?

What code should be assigned when a battery is replaced for a pacemaker?

Is the coding of a diagnostic cardiac catheterization different based on the access into the body (for example: radial versus femoral artery)?

What codes can be assigned for extremity arterial non-imaging Doppler studies?

When is 92961 used? If a patient with an implantable cardiac defibrillator (ICD) is cardioverted for atrial fib, is this the appropriate code to use?

When the AICD pulse generator (battery) is replaced due to ERI (elective replacement interval). Which ICD-10 code would be correct, T82.111A or Z45.02?

We had a patient who presented with an uncontrollable nosebleed, and the physician performed angiography of the external carotid arteries. What code would be assigned?

Is 93567 the appropriate code for the evaluation of an aortic dissection without a cardiac catheterization?

How is the following scenario coded? A patient has a SVG anastomosed to the LC obtuse marginal (OM). Next, this graft “jumps” to the RC posterolateral branch. Through the vein graft, the OM lesion is treated with angioplasty and bare metal stenting and a second lesion in the posterolateral branch of the RC is treated with angioplasty.

I have a provider who billed 93015 for a cardiovascular stress test performed in the outpatient hospital setting, and the hospital billed the following code:

93017 Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report

The provider’s claim was re-coded from 93015 to 93018. How should a cardiovascular stress test done in a facility when a physician provides supervision as well as interpretation and report?

Is code 92973 the appropriate code for aspiration of a thrombus within a coronary vessel?

Cardiology documented the following in a patient progress note on the second hospital day: “Troponins +, highest 6.4, needs cath STAT. + chest pain.” The chart has no further clarification, so what would be the principal diagnosis on discharge?