New information lays emphasis on a 'mechanical' necessity for the thrombectomy code.
In case you've been using coronary thrombectomy code +92973 for reporting a range of methods, pay attention. Thrombectomy by means of aspiration catheter is included in the intervention, as per the American Medical Association (AMA) as well as American College of Cardiology (ACC). Read this article and get an expert cardiology coding insight for accurate claims and maximized ethical reimbursement.
Take a Closer Look at +92973
The code being discussed is +92973 (Percutaneous transluminal coronary thrombectomy [List independently other than code for primary procedure]).
For years, a lot of resources have based their coding recommendations on the simple face of the definition of +92973. If you go through the descriptor, you'll find that it does not specify anything but 'Percutaneous transluminal coronary thrombectomy.
Accordingly, a general recommendation has been that you may give +92973 for a range of methods used to eliminate thrombus, including both fragmentation and aspiration catheters.
Consider the Aspiration Catheter Question
The issue: The 2011 CPT® Reference Guide meant for Cardiovascular Coding (co-published by the AMA and ACC) mentions that +92973 is correct only when the physician uses a mechanical device that fragments the thrombus and removes the clots.
What's new: A number of firms required clarification from the AMA about correct coding for +92973. The firms have lately reported independently that the AMA's response has been to back the information in the ACC/AMA publication: +92973 is not suitable for thrombectomy by aspiration catheter.
The reported AMA responses also point out that non-mechanical coronary thrombectomy is included in any other intervention carried out (for instance coronary angioplasty or stent placement). Under that interpretation, "thrombectomies performed along with aspiration devices such as Pronto and Fetch are incorporated in the intervention and not independently reportable, Thus you would require to see proof that the physician fragmented (broke up) the thrombus versus aspirated (suctioned) it to report +92973.
Confusion remains: A lot of coders maintain that they want to see a more clear guidance in the CPT® manual for +92973 and published guidance from CMS to settle the issue since it could involve changing practice policy on coding these services. Some industry experts have recommended that until CMS issues written guidance, practices should code the service consistently across the board. In other words, the recommendation is that in the absence of written guidance, you shouldn't code differently for different payers.
Bonus: Additional Tips Aid +92973 Correctness
When your documentation does support reporting +92973, keep in mind that you must not report it as an individual code. It is an add-on code and should go with either 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) or 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel).
Want to have more expert tips like this and latest cardiology billing and coding updates? Click here to read the entire article and to get access to our monthly Cardiology Coding Alert: Your practical adviser for ethically optimizing cardiology billing and coding, payment and efficiency in cardiology practices. With Cardiology Coding Alert, you get the updated cardiology -specific coding and Medical billing information delivered to you every month
In case you've been using coronary thrombectomy code +92973 for reporting a range of methods, pay attention. Thrombectomy by means of aspiration catheter is included in the intervention, as per the American Medical Association (AMA) as well as American College of Cardiology (ACC). Read this article and get an expert cardiology coding insight for accurate claims and maximized ethical reimbursement.
Take a Closer Look at +92973
The code being discussed is +92973 (Percutaneous transluminal coronary thrombectomy [List independently other than code for primary procedure]).
For years, a lot of resources have based their coding recommendations on the simple face of the definition of +92973. If you go through the descriptor, you'll find that it does not specify anything but 'Percutaneous transluminal coronary thrombectomy.
Accordingly, a general recommendation has been that you may give +92973 for a range of methods used to eliminate thrombus, including both fragmentation and aspiration catheters.
Consider the Aspiration Catheter Question
The issue: The 2011 CPT® Reference Guide meant for Cardiovascular Coding (co-published by the AMA and ACC) mentions that +92973 is correct only when the physician uses a mechanical device that fragments the thrombus and removes the clots.
What's new: A number of firms required clarification from the AMA about correct coding for +92973. The firms have lately reported independently that the AMA's response has been to back the information in the ACC/AMA publication: +92973 is not suitable for thrombectomy by aspiration catheter.
The reported AMA responses also point out that non-mechanical coronary thrombectomy is included in any other intervention carried out (for instance coronary angioplasty or stent placement). Under that interpretation, "thrombectomies performed along with aspiration devices such as Pronto and Fetch are incorporated in the intervention and not independently reportable, Thus you would require to see proof that the physician fragmented (broke up) the thrombus versus aspirated (suctioned) it to report +92973.
Confusion remains: A lot of coders maintain that they want to see a more clear guidance in the CPT® manual for +92973 and published guidance from CMS to settle the issue since it could involve changing practice policy on coding these services. Some industry experts have recommended that until CMS issues written guidance, practices should code the service consistently across the board. In other words, the recommendation is that in the absence of written guidance, you shouldn't code differently for different payers.
Bonus: Additional Tips Aid +92973 Correctness
When your documentation does support reporting +92973, keep in mind that you must not report it as an individual code. It is an add-on code and should go with either 92980 (Transcatheter placement of an intracoronary stent[s], percutaneous, with or without other therapeutic intervention, any method; single vessel) or 92982 (Percutaneous transluminal coronary balloon angioplasty; single vessel).
Want to have more expert tips like this and latest cardiology billing and coding updates? Click here to read the entire article and to get access to our monthly Cardiology Coding Alert: Your practical adviser for ethically optimizing cardiology billing and coding, payment and efficiency in cardiology practices. With Cardiology Coding Alert, you get the updated cardiology -specific coding and Medical billing information delivered to you every month
