Cardiovascular CPT in Medicine/Radiology

​Medicine Section

​Can be invasive or non-invasive : invasive does not = surgical

• cardioversion, infusion, thrombolysis, catheter placement, angioplasty

• Division is usually based on method of treatment (balloon/blade), location of treatment (aorta, mitral valve), and number of vessels

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The add on code for when one vessel gets stented and another one gets PTCA is not in the same bubble!

+92921 dont forget it if needed!​

​watch out for the add on!

Rep92928-92929

catheter inserted, deploys a stent to reinforce a vessel that has collapsed or is blocked​

​usually includes a stent

​angioplasty - ptca

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Balloon PTCA of the right coronary artery and two vessels of the left anterior descending artery

dont forget the artery modifiers!

​cardiac catheterization

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• You must know what is included in the code

• These procedures involve multiple COMPONENTS

93456 has all 3 components bundled into the code ;

93531 does not include the imaging so another code must be added if imaging was done as well​

​Let's review the vessels/branches

​https://youtu.be/nqkwkNRKJcA

Technical Component​

​-tc

Professional Component​

​-26

​CV IN THE RADIOLOGY SECTION

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​75659- angiography (tc) and injection for imaging(pC)

now injection is in surgery section & angiography is in radiology​

Must use both codes to report full service​

The equipment and technician​

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​-TC

Interpretation/Report

• the radiologist may supervise and reviews the results/provides a report

​-26

​continued

Billing a radiology code alone, means you did both (supervision and interpretation+own the equipment)....see illustrations >>​

​Cardiologist places a heart cath - 36215

Radiologist performs the angiography - 75710

Facility owns the equipement and employs the tech, so no modifier on the 75710​

​same facility

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​Cardiologist office bills his portion, the heart cath 36215

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The Radiology center who employs the radiologist and owns the equipment/tech bills 75710

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​different facilities

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​radiologist provides supervision and interpration of the results for an outside imaging company

The facility performs angiography but then sends the results to doctor to interpret​/report

doctor = 75710-26 Facility= 75710-TC​

​​Different scenario

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Multiple Choice

Which modifier, if any, goes on the procedure code for physician (radiologist):

Right heart catheterization, for angiography; supervision and interpretation

• -TC

• no modifier

• 93561

• -26

WITH contrast means IV contrast.

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Oral/Rectal contrast is considered "WITHOUT CONTRAST"​

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​with/without contrast

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CT Scan of the heart performed for evaluation of cardiac structure and morphology; including assesment of cardiac function and eval of the venous structures, with contrast, professional component

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Bilateral angiography of the arteries of the legs, with radiological supervision and interpretation, professional component

​Chapter Review

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Thrombectomy of arterial graft

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Direct repair of aneurysm and graft insertion for occlusive disease of the common femoral artery

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Removal of single-lead AICD pulse generator

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open heart repair of mitral valve on CPB

​-Homework - Ch 12, Ch 17, Ch 18 workbook!

" Read chapter 18 on your own, let me know if you have any questions/concerns. Have a great weekend!"