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93505 Does Not Ensure Payment But Goes With Heart Procedures
Does your anesthesiologist participates in cardiac surgery case
? If so, chances are he uses a pulmonay artery (or PA) catheter during the procedure. PA catheters make the list of monitoring devices you can often code separately from other services; as such, you should keep these two tips in mind if you want sucessful claims coming your way.Zoom in on the proper code
Your doctor can select between various types of PA catheters. Some PA catheters allow the anesthesiologist to pace the heart temporarily, which might be important for patients with underlying cardiac rhythm disturbances. You might report diagnoses like 426. X, 427.x or 428.x in that situation. Others allow the doctor to continually monitor cardiac output and/or monitor mixed venous oxygen saturation.
Coding key: Irrespective of which PA catheter the anesthesiologist selects, he places them all the same way and CPT covers all types with a single code. Report any PA catheter insertion with 93503.
Steer clear of extra TEE coding
Anesthesiologists also use transesophageal echocardiography (or TEE) to help maximize a patient's cardiac function and optimize fluid status. Your doctor might use a PA catheter and TEE during a single case; however do not assume that you will be paid for both lines.
Whether a payer reimburses for TEE depends partly on the TEE's purpose and your specific payers. Do remember that an intraoperative TEE is not the same as at TEE for monitoring purposes.
No-go: Medicare will not pay for TEE services used only for monitoring. It considers monitoring as part of the global anesthesia fee, and some other payers agree. According to the CCI, you cannot bill monitoring services using any modifier. However, keep your claim compliant by reporting the service with 93318.
Possible pay: Insurance companies vary on whether they'll pay for monitoring, diagnostic TEE usage. Some payers might require your doctor to be credentialed to provide these services. Report the right codes from 93312-93314 or 93315-93317 for diagnostic services.
Final tip: Your anesthesiologist must carry out the placement image, acquisition and interpretation to bill correctly.
For more tips on cardiac anesthesia coding tips, sign up for a one-stop medical coding website. Such a site comes with a free code lookup tool to assist you in your coding. In fact, you can even get an online CPT Assistant when you get onboard one. You even stand to gain free coding updates from time to time.
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