interventional cardiology is a branch of cardiology that deals specifically with the catheter-based treatment of structural heart disease. The main advantages of using the interventional cardiology or radiology approach are the avoidance of scarring and pain, and the long postoperative recovery. It involves the removal of clots from occluded coronary arteries and the deployment of stents and balloons through a small hole made in a major artery.
With the introduction of the new cardiology coding update, the coding of interventional cardiovascular services has undergone considerable changes that have made coding and billing for services rendered complex and confusing. This year, cardiologists will work with complex codes that are better designed to describe the procedures and intensive care offered to patients, but payment for services will reach an all-time low.
The AMA has approved 13 new codes for reporting percutaneous coronary interventions, including core codes for angioplasty, atherectomy, and stenting. A specific set of codes for percutaneous transluminal revascularization for acute total or subtotal occlusion is also included when codes 92941 or 92943 are used.
Generally, when a cardiac intervention is performed on the main vessel along with an additional branch, a single code is used to report it. But with the new codes, only one base code is required to report the procedure along with an additional 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 ensure the appreciation and reimbursement they deserve for the complicated and time-consuming procedures they perform.
But there are doubts about the use of these new codes. Under the 2013 Medicare Physician Fee Schedule final rule issued on November 1, it has been said that physicians would not be paid for the additional codes. According to officials, the reason for rejecting the supplemental codes is fear that this may encourage doctors to increase stenting unnecessarily.
According to SCAI officials, the Medicare fee schedule rule is still being considered to determine whether physicians can report the additional CPT codes, although Medicare will not pay for them.
There are also financial implications. Although the CMS decision is a surprise, it will help lessen the financial impact on physicians, as Medicare increased payment for basic codes when the decision was made that additional codes will not be paid for.
Regardless of the approach followed, experts say, physicians will see a significant 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 codes 92980-92984, 92995 and 9295 and 4 and 92995.