2023 is now in full swing with new coding active and effective. Among the noteworthy changes for cardiology coding include new category III codes. By grasping a better understanding of the codes and rationale behind them, cardiology CPT® coders and healthcare compliance professionals can better overcome any challenges while coding correctly and achieving full reimbursement. Let’s explore the changes for success throughout 2023.
| +0715T | Percutaneous transluminal coronary lithotripsy (List separately in addition to code for primary procedure) |
0715T should be reported in conjunction with 92920, 92924, 92928, 92933, 92937, 92941, 92943, and 92975. Note that this code should be reported in addition to the primary interventions.
The following code was created for the supply used.
| C1761 | Catheter, transluminal intravascular lithotripsy, coronary |
Code 0716T describes cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score. During this service, a noninvasive sensor is placed on patient’s chest to assess for coronary artery disease risk. Understand that this code may be used to report for patients experiencing:
| 0716T | Cardiac acoustic waveform recording with automated analysis and generation of coronary artery disease risk score |
Coronary lithotripsy example:
Indication: Patient having an acute MI. Rushed from ER to table within 90 minutes after arrival.
Urgent diagnostic coronary angiogram performed which revealed culprit vessel LAD with 90% blockage with 70% blockages in the LC and RC. Interventional Cardiologist performs lithotripsy on the LAD and then deploys a drug-eluting stent within the left anterior descending and performs angioplasty within the left circumflex and the right coronary arteries.
Coding:
| Physicians | Hospital |
|---|---|
| – 93454 59 or XU | – 93454 59 or XU |
| – 0715T LD | |
| – 92941 LD | – C9606 LD |
| – 92920 LC | – 92920 LC |
| – 92920 RC | – 92920 RC |
Three primary (base) codes are used because three separate coronary vessels are treated The stenting of the LAD is reported with code 92941/C9606 (DES) The angioplasties of the LCX and RCA are each reported with code 92920 Lithotripsy reported with add-on code 0715T using primary code of 92941.
When is this code reported? Use 0742T in conjunction with 78451 and 78452. For absolute quantification of myocardial blood flow [AQMBF] with positron emission tomography [PET], use 78434).
| +0742T | Absolute quantitation of myocardial blood flow (AQMBF), single-photon emission computed tomography (SPECT), with exercise or pharmacologic stress, and at rest, when performed (List separately in addition to code for primary procedure) |
0742T has been established to report absolute quantitation of myocardial blood flow (AQMBF) single-photon emission computed tomography (SPECT).
Understand that AQMBF is a new procedure that:
Note that AQMBF is an emerging technology that uses different processes, software, imaging cameras, and workflow.
These are not all the tips and insights necessary for full comprehension of category III coding and cardiology. Explore more coding knowledge and additional pressing topics to master compliance and coding with our 2023 Cardiology Coding Update on-demand webcast. No matter the challenges to your revenue and compliance, you’ll take away workable solutions from this annual webcast. In addition, you’ll get in-depth guidance with all 2023 code changes clear definitions and actionable steps to ensure correct coding. Take control of the chronically challenging issues, and changes that may put your facility at risk for claim denials, underpayment, and auditor action.
UnitedHealthcare (UHC) Medicare Advantage will begin reinforcing denialsbased on its interpretation of the International Classification of Disease, 10 thEdition, Clinical Modification (ICD-10-CM) Excludes 1.(https://www.uhcprovider.com/content/dam/provider/docs/public/policies/medadv-reimbursement/rpub/UHC-MEDADV-RPUB-JAN-2026.pdf) As
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