Well, as we all know, there’s a need for comprehensive anatomical specificity both in the documentation and cardiology codes. But with the prevalence of multiple co-morbidities and the advances in technology, cardiovascular coding can be quite challenging. 2021 has introduced several new cardiology codes and guidelines that demand healthcare professionals stay on track with documentation requirements, reimbursement, and compliance to achieve their revenue goals.

In 2021, the Category I section and Category III section of the CPT codebook feature new cardiology codes in the Cardiovascular System section to accommodate innovation, new technology, and the development of digital health solutions. Here, in this article, let’s see important cardiology codes to note in 2021.

 

List of Cardiology codes to Note in 2021:

3 New Shunting Procedure Codes:

  • There are 3 new shunting procedure codes for congenital cardiac anomalies as well as added introductory guidelines.
  • Code 33741: This code is for transcatheter atrial septostomy (TAS) for congenital cardiac anomalies to create effective atrial flow, including all imaging guidance by the proceduralist, when performed, any method (e.g., Rashkind, Sang-Park, balloon, cutting balloon, blade). Diagnostic cardiac catheterization is not typically performed during this procedure and can therefore be reported separately when performed.
  • Code 33745:This code is for transcatheter intracardiac shunt creation using a stent for effective intracardiac flow. The procedure includes intracardiac stent placement, target zone angioplasty, diagnostic cardiac catheterization, and imaging guidance when performed.
  • Code +33746:add-on code for use with 33745 for each additional shunt location.

 

Interesting points to note while using these codes:

  • Do assign accurate codes based on the method used to create the shunt.
  • Do review the notes for these codes.
  • Even though multiple stents are used in 33745, do report the code only once.

 

8 New Cardiology Codes for Continuous Cardiac Monitoring and Detection:

  • There are eight new cardiology codes that have been added under Cardiovascular Monitoring Services. They are:
  • 93241: This code is used for external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review, and interpretation
  • 93242: This code is used for external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; recording (includes connection and initial recording)
  • 93243: This code is used for external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; scanning analysis with report
  • 93244: This code is used for external electrocardiographic recording for more than 48 hours up to 7 days by continuous rhythm recording and storage; review and interpretation
  • 93245: This code is used for external electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; includes recording, scanning analysis with report, review, and interpretation
  • 93246:This code is used for external electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; recording (includes connection and initial recording)
  • 93247:This code is used for external electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; scanning analysis with report
  • 93248:This code is used for external electrocardiographic recording for more than 7 days up to 15 days by continuous rhythm recording and storage; review and interpretation
  • These codes will allow the reporting of external EKG recordings for more than 48 hours and up to 7 days or for more than 7 and up to 15 days.

 

Percutaneous Ventricular Assist Device (VAD):

  • There are two new codes for percutaneous insertion of an endovascular cardiac assist device. They are:
  • 33995: This code is used for insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; right heart, venous access only.
  • 33997: This code is used for removal of percutaneous right heart ventricular assist device, venous cannula, at the separate and distinct session from insertion.
  • 33990: This code is used for insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; left heart arterial access only.
  • 33991: This code is used for insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; left heart, both arterial and venous access, with trans-septal puncture.
  • The above codes 33990 and 33991 have been revised to specify that the procedure involves the left heart.
  • 33992: This code is used for removal of percutaneous left heart ventricular assist device, arterial or arterial, and venous cannula(s), at the separate and distinct session from insertion.
  • The code 33992 has been revised to report the removal of the ventricular assist device from the left heart.
  • 33997:This code is used for removal of percutaneous right heart ventricular assist device, venous cannula, at the separate and distinct session from insertion.
  • 33993: This code is used for repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at the separate and distinct session from insertion.

 

Interatrial Septal Shunt Device:

  • A new code is assigned for this type of shunt, also known as an “IASD”.
  • 0613T: This code is used for percutaneous transcatheter implantation of interatrial septal shunt device, including right and left heart catheterization, intracardiac echocardiography, and imaging guidance by the proceduralist, when performed.  Coders must be sure to read the extensive exclusion notes.
  • This particular interatrial shunt device reduces left atrial pressure, improves hemodynamics and prevents adverse remodeling in an ovine heart failure model.
  • It’s a modified technique of stent fenestration of the interatrial septum which helps patients with pulmonary hypertension.

 

Replacement of Substernal Defibrillator Generator:

  • There were no codes earlier for just the removal and replacement of the substernal generator alone.
  • 0580Tis used for removal without any replacement.
  • 0614Tis used for removal and replacement of substernal implantable defibrillator pulse generator.
  • Never report 0614T with 33262, 0571T, 0572T, 0575T, 0576T, 0577T, and 0580T.

 

Automated Quantification of Plaque

  • 0623T: Automated quantification and characterization of coronary atherosclerotic plaque to assess the severity of coronary disease, using data from coronary computed tomographic angiography; data preparation and transmission, computerized analysis of data, with a review of computerized analysis output to reconcile discordant data, interpretation, and report.
  • 0624T: Data preparation and transmission
  • 0625T: Computerized analysis of data from coronary computed tomographic angiography
  • 0626T: Review of computerized analysis output to reconcile discordant data, interpretation, and report

 

While using cardiology codes, it’s essential to use accurate codes along with essential modifiers for better revenue generation. Outsourcing is always a suggested option. It is advisable for healthcare professionals to choose the best ones for a great billing experience.

 

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