Cardiovascular coding with PCI and CPT and NCCI guidelines.
The post Cardiovascular Coding: Solve the PCI Puzzle Using CPT® and NCCI Guidelines appeared first on AAPC Knowledge Center.
Laureen shows you her proprietary “Bubbling and Highlighting Technique”
Download your Free copy of my "Medical Coding From Home Ebook" at the top right corner of this page 2018 CPC Practice Exam Answer Key 150 Questions With Full Rationale (HCPCS, ICD-9-CM, ICD-10, CPT Codes) Click here for more sample CPC practice exam questions with Full Rationale Answers Click here for more sample CPC practice exam questions and answers with full rationaleCardiovascular coding with PCI and CPT and NCCI guidelines.
The post Cardiovascular Coding: Solve the PCI Puzzle Using CPT® and NCCI Guidelines appeared first on AAPC Knowledge Center.
Familiarize yourself with the 2020 CPT® code updates for the cardiovascular system.
The post Explore 2020 Cardiovascular System Code Changes appeared first on AAPC Knowledge Center.
Cardiovascular disease is the world’s number one killer today, but it doesn’t need to be this way. September is National Cholesterol Education Month and September 29 is World Heart Day. These observances raise awareness about cardiovascular disease (CVD), cholesterol, and stroke, encouraging individuals, families, communities, and governments to take action now. Join the movement and […]
The post Cardiovascular Screening: Combating the World’s #1 Killer appeared first on AAPC Knowledge Center.
Cardiovascular Associates, P.C. has consented to pay $ 399,230.35 to settle asserts that they submitted false cases to the United States for administrations not rendered. Cardiovascular Associates P.C. is a therapeutic practice with workplaces situated in Rockville, Olney, Laurel and Germantown, Maryland.
The post Cardiovascular Associates, P.C. Consents to Pay the United States Over $ 399,000 to Settle False Claims Act Allegations Relating to Improper Billing Practices appeared first on The Coding Network.
PROCEDURES
1. Aortic arch angiogram
2. Selective left subclavian angiogram with the left arm runoff
3. Percutaneous transluminal angioplasty and balloon expandable bare-metal stent placement to left subclavian artery.
PROCEDURE NOTE
Informed consent was obtained after explaining risks and benefits to the patient. Right groin was draped and prepped in the sterile fashion. Patient was premedicated with 3 mg Versed and 125 mg fentanyl altogether IV. After injecting 2% lidocaine in the right groin, right common femoral artery was accessed using micropuncture needle and a 5 French sheath was inserted without any difficulty. Using 5 French angled pigtail catheter, ascending aortogram was performed. Patient was proceeded with intervention of left subclavian artery. Patient remained hemodynamically stable and tolerated procedure well.
AORTIC ARCH AORTOGRAM
Mild atherosclerotic disease was noted in the distal aortic arch. Right brachiocephalic trunk was patent with no significant disease. Left common carotid artery was patent with no significant disease. Left subclavian artery had a proximal 90% stenosis.
PERCUTANEOUS INTERVENTION OF LEFT SUBCLAVIAN ARTERY
6 French 90 cm destination sheath was advanced over Magic torque wire without any difficulty. Heparin was used for anticoagulation. 0.035 Magic torque wire was advanced and lesion of proximal left subclavian artery was successfully crossed without difficulty. 6.0 x 20 mm balloon was advanced and proximal subclavian artery stenosis was predilated at 10 atm. 8.0 x 27 mm express LD balloon expandable stent was advanced the stent was deployed covering lesion of proximal left supplement artery at 8 atm. Stent was postdilated using 8.0 x 20 mm balloon at 10 atm couple of times. Subsequent angiogram revealed wide-open supplement artery with 0% residual stenosis and a brisk antegrade flow in the distal subclavian artery. Left arm runoff was performed and found to have occluded distal ulnar artery and forearm which was reconstituted via collaterals at the level of left wrist. Radial artery flow was normal. She had a palpable good radial pulse at the end of the procedure.
IMPRESSION
1. High-grade 90% stenosis of proximal left supplement artery.
2. Successful percutaneous intervention and balloon expandable stent (BMS) placement to left subclavian artery.
3. Occluded distal left ulnar artery with collaterals -likely chronic
RECOMMENDATIONS
Patient is to continue on her Plavix for minimum 4-6 weeks. Continue aspirin 81 mg as before. Patient had CT angiogram of neck which showed possible distal aortic arch mural thrombus versus penetrating ulcer. She has distal embolization of left ulnar artery which appears chronic with collaterals. Will discuss with hematology regarding need for anticoagulation.
I choose 75605 – 26, 75710 – 26 and 37236.
Thank you for any help.
I have a quick question, my provider constantly documents either negative or positive Homan’s sign on his patients and he often bills 99203. On every exam he assesses range of motion (musculoskeletal), tenderness (skin), he documents that the patient is neurovascular intact (neuro) and there are vitals (constitutional); that’s 4 elements which corresponds to an Expanded Problem Focused Exam (99202). He also documents Homan’s sign which according to google it detects DVT and leads me to believe that I should be giving credit towards Cardio under the exam, which is what the provider needs to bill 99203 (detailed exam – 5 exam elements).
Can anyone tell me if I can give credit under Cardiovascular for the Homan’s sign?
Thank you.
Lately I’ve heard a lot of buzz about the AAPC’s credential, Certified Interventional Radiology Cardiovascular Coder (CIRCC). Interventional radiology (IR) coders are in demand because of the complexity of the field and the notoriously high error rates seen on audits. It may sound like a great credential to get, but before you make any sudden movements, here’s what you need to know about the CIRCC exam.
Why this credential exists
I’ve been coding now for 22 years and I’ve seen quite a bit. I helped train the workforce in ICD-10-CM and ICD-10-PCS. I’ve audited ICD-9, ICD-10, CPT and HCPCS codes. I’ve read the Federal Register on DRGs and APCs. But the hardest thing I’ve ever had to learn to code is IR and cardiology. The coding rules are complicated, ever changing, and often inconsistent for different parts of the body. Learning how to code IR and cardiology procedures by just looking at the CPT book is tough enough, but not all the rules are written there. There are other societies that develop suggested guidelines and then there are the payer’s rules and interpretations. In a hospital setting, an understanding of IR and cardiology coding also usually requires an understanding of hospital charging and how departments are credited revenue. This credential exists to show that you’ve mastered these areas of coding. In my mind, this is the most difficult area of coding there is.
This is not an entry-level credential
I took the CIRCC exam four years ago with about 10 years of experience under my belt. It was a tough exam. As a matter of fact, it was the hardest multiple choice exam I’ve ever taken and I would put it up there with the Certified Coding Specialist (CCS) test as one of the toughest. If you are thinking you will get the CIRCC and then land a job as an IR coder without any experience, think again. This is the test you take after you’ve been coding those types of cases for a long time and feel confident in your abilities. AAPC recommends, but does not require, at least two years of coding experience before taking the CIRCC exam.
What’s on the test
The CIRCC exam is spotlighted for its focus on IR coding, but it also includes cardiology procedures. The procedures we’re talking about are surgical-type procedures done in a radiology suite or cardiac cath lab using radiological (fluoroscopic) guidance. For IR, this can be vascular studies (angiograms) and interventions (e.g., angioplasty, stenting, thrombectomy) or nonvascular procedures (e.g., placement of biliary stents, nephrostomies, and fluoroscopically-guided biopsies). For cardiology, this can be diagnostic cardiac catheterization, angioplasty and stenting, and cardiac electrophysiology studies and arrhythmia ablations. If you don’t know what any of that means, I don’t recommend taking the test until you learn more!
What it costs
At the time of this writing, the cost to sit for the CIRCC exam is $ 400. But the cost of taking the CIRCC doesn’t end when you register and pass the exam. Like other credentials, you need continuing education units (CEUs) to maintain the certification. But unlike most other AAPC credentials, there are limited vendors from which you can get those CEUs. Before you decide to take the test, look at the CEU requirements and visit the vendor websites (the AAPC has links) to see how much your CEUs will cost you and be very realistic about what you can afford. If your primary job is coding these types of cases, check with your employer to see if they will reimburse you for any of the costs. This is an expensive credential to maintain, but if it’s valued by your employer, they may cover the costs.
Read all about it
I could regurgitate the contents of the AAPC’s website about the CIRCC exam, but instead of doing that, I will direct you to their website with this simple instruction: Do your homework! There is a plethora of information on the AAPC’s website for this exam and it will tell you everything you need to know from the breakdown of the exam questions, approved manuals and materials (yes, you can bring anatomy cards showing selective vascular ordering), certification requirements, history of the exam, and FAQs. If you were going to spend $ 400 on a new smartphone, you would probably read up on the different models before making a final decision. Why wouldn’t you also do this for a credential? Don’t take this exam until you’ve read all the fine print.
Preparing for the exam
Once you decide that you’re ready to pull the plug and take the test, it’s time to prepare. Even if you’ve coded these cases for a long time, there is still preparation to be done. Here is my list of recommendations: