DOCSLIB.ORG

2020 EP Reimbursement and Coding Guide Physicians and Facilities RESOURCES to ASSIST YOU with the REIMBURSEMENT PROCESS

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
2020 EP Reimbursement and Coding Guide Physicians and Facilities RESOURCES to ASSIST YOU with the REIMBURSEMENT PROCESS 2020 EP Reimbursement and Coding Guide Physicians and Facilities RESOURCES TO ASSIST YOU WITH THE REIMBURSEMENT PROCESS Resources to assist you with the reimbursement process 2020 Electrophysiology Services Patient Name: Date: Physician: Facility: COMPREHENSIVE EP STUDIES ECHOCARDIOGRAPHY 93619 Comprehensive EPS without induction of arrhythmia 93306 Transthoracic echo, complete with doppler, color flow 93620 Comprehensive EPS with (attempted) induction of arrhythmia 93307 Transthoracic echo, complete without doppler +93621 Left atrial or coronary sinus pacing & recording (w/ 93620, 93653, 93654) 93308 Transthoracic echo, limited or follow-up +93622 Left ventricular pacing & recording (w/ 93620, 93653, 93656) 93312 Transesophageal echo, complete +93320 Spectral Doppler echo (add-on with 93312) MAPPING & ADD-ON PROCEDURES +93321 Spectral Doppler echo, limited or follow-up (add-on with 93308, 93312) +93609 Catheter mapping of tachycardia (w/ 93620, 93653, 93656) +93325 Color flow Doppler (add-on with 93308, 93312) +93613 3-D mapping (w/ 93620, 93653, 93656) +0439T Myocardial contrast perfusion echocardiography +93623 Drug stimulation (w/ 93610, 93612, 93619, 93620, 93653, 93654, 93656) +93356 Myocardial strain imaging using speckle tracking-derived assessment INDIVIDUAL STUDIES & OTHER PROCEDURES EP EVALUATION OF ICD 93600 Bundle of His recording 93642 EP analysis of transvenous ICD with induction of VT/VF 93602 Intra-atrial recording 93644 EP analysis of subcutaneous ICD with induction of VT/VF 93603 Right ventricular recording 0577T EP analysis of substernal ICD with induction of VT/VF 93610 Intra-atrial pacing 93612 Intraventricular pacing PERI-PROCEDURAL DEVICE EVALUATIONS 93618 Induction of arrhythmia by electrical pacing 93286 Peri-procedure evaluation & program, pacemaker (may report x 2) 93615 Esophageal recording of atrial electrogram 93287 Peri-procedural eval & program, transven ICD (x2) (with 93619, 93620, 93616 Esophageal atrial electrogram with pacing 93653) 93624 Follow-up EP study with pacing & recording, (attempted) induction 93261 Peri-procedural eval & program, sub-Q ICD (x2) (with 93619, 93620, 93660 Tilt table study 93653) ABLATIONS MISCELLANEOUS PROCEDURES 93650 AV node ablation 93451 Right heart cath (diagnostic) 93653 Comprehensive EPS with atrial ablation 93452 Left heart cath, retrograde 93654 Comprehensive EPS + 3D mapping with ventricular ablation 93453 Right & left heart cath +93655 Ablate additional discrete arrhythmia focus (w/ 93653, 93654, 93656) 36005 Contrast injection for venography 93656 Comprehensive EPS + transseptal + ablate pulmonary veins for Afib 75820 Venography, extremity, unilateral, S&I +93657 Ablate additional RT or LT atrial site for Afib (with 93656) 93503 Swan-Ganz monitoring catheter placement INTRACARDIAC ECHO / TRANSSEPTAL ACCESS COMMON MODIFIERS +93662 Intracardiac echocardiography -22 Increased procedural service (submission of report / documentation required) +93462 Transseptal or transapical puncture (w/ 93653, 93654) -26 Professional component -52 Reduced services (portion intentionally omitted at physician’s election) CARDIOVERSION / PACING -53 Discontinued procedure (terminate without completion – physician claims) 92960 Cardioversion, elective, external -59 Distinct procedural service (separately identifiable) Cardioversion, elective, internal 92961 -XE Separate Encounter Temporary transcutaneous pacing 92953 -XS Separate Structure -XP Separate Practitioner ELECTROCARDIOGRAMS -XU Unusual Non-Overlapping Service 93000 Electrocardiogram, complete -73 Discontinued procedure prior to administration of anesthesia (OP facility) 93010 Electrocardiogram, interpretation & report only -74 Discontinued procedure after administration of anesthesia (OP facility) 93025 Microvolt T-wave alternans GD Units of service exceeds medically unlikely edit value and represents reasonable and necessary services Notes: Procedures identified with a + symbol preceding the code are designated “add-on” codes; may not be reported stand-alone. Bill in addition to the primary service or procedure. Many of these codes require modifier -26 on physician claims when performed in a facility setting (eg, hospital inpatient or outpatient). THERMOCOOL® Navigation Catheters are approved for drug refractory recurrent symptomatic paroxysmal atrial fibrillation, when used with CARTO® 3 Systems (excluding NAVISTAR® RMT THERMOCOOL® Catheter). Reimbursement and Coding and Reimbursement Electrophysiology EP Procedure Documentation Coding Guide Frequently Asked Questions Coding Checklist Best Practices Online HCPCS C-Code Finder Coding & Reimbursement Webinars Access to Biosense Webster, Inc. Reimbursement Support Services FOR ADDITIONAL QUESTIONS OR INFORMATION CONTACT: [email protected] 800.362.2048 2 Electrophysiology Diagnostic, Ablation, and Intracardiac Echocardiography Guided Transcatheter Procedures This guide has been developed to assist you in obtaining physician payment and hospital reimbursement for: • Electrophysiology (EP) diagnostic and ablation procedures • The acquisition of radiological images • EP and Cardiology procedures that may utilize intracardiac echocardiography (ICE) These procedures may be a covered service if they meet all of the requirements established by Medicare and private payers. It is essential that each claim be coded properly and supported with appropriate documentation in the medical record. TABLE OF CONTENTS PHYSICIAN SERVICES 4-7 CPT® Codes OUTPATIENT FACILITY SERVICES 8 Ambulatory Payment Classifications (APCs) INPATIENT FACILITY SERVICES 9 Medicare Severity Diagnosis Related Groups (MS-DRGs) PROCEDURE CODES 10-11 ICD-10-CM Procedure Codes DIAGNOSIS CODES 12-14 ICD-10-CM Diagnosis Codes HCPCS CODES FOR BIOSENSE WEBSTER, INC. PRODUCTS 15-16 NOTES 17 The information is provided to assist you in understanding the reimbursement process. It is intended to assist providers in accurately obtaining reimbursement for health care services. It is not intended to increase or maximize reimbursement by any payer. We strongly suggest that you consult your payer organization with re gard to local reimbursement policies. The information contained in this document is provided for information purposes only and represents no statement, promise or guarantee by Biosense Webster, Inc. concerning levels of reimbursement, payment or charge. Similarly, all CPT® & HCPCS codes are supplied for information purposes only and represent no statement; promise or guarantee by Biosense Webster, Inc. that these codes will be appropriate or that reimbursement will be made. Third party trademarks used herein are trademarks of their respective owners. Important information: Prior to use, refer to the instructions for use supplied with this device for indications, contraindications, side effects, warnings and precautions. This product can only be used by healthcare professionals www.biosensewebster.com/reimbursement 3 PHYSICIAN SERVICES CPT® codes and Medicare Physician Fee Schedule values for Electrophysiology Diagnostic, Ablation, and Intracardiac Echocardiography Guided Transcatheter Procedures are indicated below. Please note that when reporting ablation therapy codes (93653-93657), the single site electrophysiology studies (93600-93603, 93610, 93612, 93618) and the comprehensive electrophysiology study codes (93619, 93620) are included and may not be reported separately. Other procedures are also bundled into some ablation codes, but should be reported separately with others: review the descriptors and parenthetical notes carefully. Moderate sedation is no longer bundled into CPT® codes as of 2017, and so may be reported separately, although Medicare and some other payers only reimburse the first 15 minutes in a facility setting. There were no revisions to instructional notes or code descriptors for 2020. Intracardiac Electrophysiological Procedures 2020 National 2020 Work 2020 Total Average Medicare CPT® Code2 Description RVUs RVUs Reimbursement3 Left heart catheterization by transseptal puncture through intact + 93462 3.73 6.10 $220 septum or by transapical puncture 93600-26 Bundle of His recording 2.12 3.45 $125 93602-26 Intra-atrial recording 2.12 3.38 $122 93603-26 Right ventricular recording 2.12 3.38 $122 Intraventricular and/or intra-atrial mapping of tachycardia site(s) + 93609-26 with catheter manipulation to record from multiple sites to identify 4.99 8.05 $291 origin of tachycardia 93610-26 Intra-atrial pacing 3.02 4.74 $171 93612-26 Intraventricular pacing 3.02 4.69 $169 + 93613 Intracardiac electrophysiologic three-dimensional mapping 5.23 8.63 $311 Esophageal recording of atrial electrogram with or without 93615-26 0.74 1.09 $39 ventricular electrogram(s); 93616-26 …with pacing 1.24 1.72 $62 93618-26 Induction of arrhythmia by electrical pacing 4.00 6.39 $231 Comprehensive electrophysiologic evaluation with right atrial pacing and recording, right ventricular pacing and recording, His 93619-26 bundle recording, including insertion and repositioning of multiple 7.06 11.33 $409 electrode catheters, without induction or attempted induction of arrhythmia Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction 93620-26 or attempted induction of arrhythmia; with right atrial pacing 11.32 18.16 $655 and recording, right ventricular pacing and recording, His bundle recording …with left atrial pacing and recording from coronary sinus or left + 93621-26 2.10 3.40 $123 atrium + 93622-26 …with
Load more

Recommended publications
  • Resting Coronary Flow Velocity in The
    European Heart Journal – Cardiovascular Imaging (2012) 13,79–85 CLINICAL/ORIGINAL PAPERS doi:10.1093/ehjci/jer153 Resting coronary flow velocity in the functional evaluation of coronary artery stenosis: study on sequential use of computed tomography angiography and transthoracic Doppler Downloaded from https://academic.oup.com/ehjcimaging/article/13/1/79/2397059 by guest on 30 September 2021 echocardiography Esa Joutsiniemi 1, Antti Saraste 1,2*, Mikko Pietila¨ 1, Heikki Ukkonen 1,2, Sami Kajander 2, Maija Ma¨ki 2,3, Juha Koskenvuo 3, Juhani Airaksinen 1, Jaakko Hartiala 3, Markku Saraste 3, and Juhani Knuuti 2 1Department of Cardiology, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland; 2Turku PET Centre, Kiinamyllynkatu 4-8, 20520 Turku, Finland; and 3Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland Received 10 March 2011; accepted after revision 2 August 2011; online publish-ahead-of-print 30 August 2011 Aims Accelerated flow at the site of flow-limiting stenosis can be detected by transthoracic Doppler echocardiography (TTDE). We studied feasibility and accuracy of sequential coronary computed tomography angiography (CTA) and TTDE in detection of haemodynamically significant coronary artery disease (CAD). ..................................................................................................................................................................................... Methods We prospectively enrolled 107 patients with intermediate (30–70%) pre-test likelihood of CAD. All patients under- and results went CTA using a 64-slice scanner. Using TTDE, the ratio of maximal diastolic flow velocity to pre-stenotic flow velocity (M/P ratio) was measured in the coronary segments with stenosis in CTA. In all patients, the results were compared with invasive coronary angiography, including measurement of fractional flow reserve when appropriate.
    [Show full text]
  • Deep Venous Thrombosis with Suspected Pulmonary Embolism
    Thoracic Imaging Peter A. Loud, MD Deep Venous Thrombosis Douglas S. Katz, MD Dennis A. Bruce, MD with Suspected Pulmonary Donald L. Klippenstein, MD Zachary D. Grossman, MD Embolism: Detection with Combined CT Venography Index terms: Computed tomography (CT), 1 angiography, 9*.129142, and Pulmonary Angiography 9*.12915, 9*.12916 Embolism, pulmonary, 60.72 Pulmonary angiography, 944.12914, 944.12915, 944.12916 PURPOSE: To determine the frequency and location of deep venous thrombosis at Veins, thrombosis, 9*.751, 9*.12914 computed tomographic (CT) venography after CT pulmonary angiography in a large series of patients clinically suspected of having pulmonary embolism and to Radiology 2001; 219:498–502 compare the accuracy of CT venography with lower-extremity venous sonography. Abbreviation: MATERIALS AND METHODS: Venous phase images were acquired from the DVT ϭ deep venous thrombosis diaphragm to the upper calves after completion of CT pulmonary angiography in 650 patients (373 women, 277 men; age range, 18–99 years; mean age, 63 years) 1 From the Department of Radiology, to determine the presence and location of deep venous thrombosis. Results of CT Roswell Park Cancer Institute, Elm and Carlton Sts, Buffalo, NY 14263 (P.A.L., venography were compared with those of bilateral lower-extremity venous sonog- D.L.K., Z.D.G.), and the Department raphy in 308 patients. of Radiology, Winthrop University Hospital, Mineola, NY (D.S.K., D.A.B.). RESULTS: A total of 116 patients had pulmonary embolism and/or deep venous From the 1999 RSNA scientific assem- thrombosis, including 27 patients with pulmonary embolism alone, 31 patients with bly.
    [Show full text]
  • Spring Programme 2011
    Faculty of Radiologists Royal College of Surgeons in Ireland Combined Spring Meeting 8th & 9 th April 2011 Venue: Castlemartyr Hotel, Co. Cork. Programme Faculty of Radiologists, Royal College of Surgeons in Ireland CPD Credits Awarded: 5 Royal College of Radiologists credits are applied for. Friday 8 th April 2011 3.30-4.30pm Registration 4.30-5.30pm Stroke in 2011, Moderator: Dr. Ian Kelly, Waterford Regional Hospital 4.30-5.00pm Acute Stoke Imaging. Dr Noel Fanning, Cork University Hospital, Cork 5.00-5.30pm Stroke: A clinical perspective. Dr. George Pope, John Radcliffe Hospitals, Oxford 5.30-6.30pm Moderator: Dr. Adrian Brady, Dean, Faculty of Radiologists Belfast to Bosnia and Autopsy to Virtopsy Dr. Jack Crane, State Pathologist, NI 8pm Dinner Saturday 9 th April 2011 8.30-9.00am Registration 9.00-10.00am Liver hour. Moderator: Dr John Feeney, AMNCH, Dublin 9.00-9.30am Liver imaging pre metastatectomy. Dr. Peter MacEneaney, Mercy University Hospital, Cork 9.30-10.00am Parenchymal and focal liver biopsy - when and how. Dr Stephen J Skehan St Vincent's University Hospital, Dublin 10.00-11.00am Paediatric Hour. Moderator: Dr. Stephanie Ryan, The Children’s University Hospital Temple Street, Dublin 10.00-10.30am Paediatric Abdominal Emergencies. Dr Eoghan Laffan, The Children’s, University Hospital Temple Street, Dublin 10.30-11.00am Non Accidental Injury. Dr Conor Bogue, Cork University Hospital, Cork 11.00-11.30am Tea/Coffee Break and Poster Exhibition 11.30-12.30pm MSK Hour. Moderator: Dr Orla Buckley, AMNCH, Dublin 11.30-12.00pm Image guided joint interventions.
    [Show full text]
  • The Challenge of Assessing Heart Valve Prostheses by Doppler Echocardiography
    Editorial Comment The Challenge of Assessing Heart Valve Prostheses by Doppler Echocardiography Helmut Baumgartner, MD, Muenster, Germany The assessment of prosthetic valve function remains challenging. by continuous-wave Doppler measurement. Using these velocities Echocardiography has become the key diagnostic tool not only be- for the calculation of transvalvular gradients results in marked overes- cause of its noninvasive nature and wide availability but also because timation of the actual pressure drop across the prostheses.6 The fact of limitations inherent in alternative diagnostic techniques. Invasive that this phenomenon more or less disappears in malfunctioning bi- evaluation is limited particularly in mechanical valves that cannot leaflet prostheses when the funnel-shaped central flow channel ceases be crossed with a catheter, and in patients with both aortic and mitral to exist because of restricted leaflet motion makes the interpretation valve replacements, full hemodynamic assessment would even of Doppler data and their use for accurate detection of prosthesis mal- require left ventricular puncture. Although fluoroscopy and more function even more complicated.7 Furthermore, the lack of a flat ve- recently computed tomography allow the visualization of mechanical locity profile and the central high velocities described above cause valves and the motion of their occluders, the evaluation of prosthetic erroneous calculations of valve areas when the continuity equation valves typically relies on Doppler echocardiography. incorporates such measurements.8 For these reasons, the analysis of Although Doppler echocardiography has become an ideal nonin- occluder motion using fluoroscopy (in mitral prostheses, this may vasive technique for the evaluation of native heart valves and their also be obtained on transesophageal echocardiography) remains es- function, the assessment of prosthetic valves has remained more dif- sential to avoid the misinterpretation of high Doppler velocities across ficult.
    [Show full text]
  • CT Venography: Technique and Indications
    VENOUS CT Venography: Technique and Indications A brief summary of how to perform indirect and direct CT venography and when this imaging modality can be helpful in diagnosing venous disease. BY ANA MARIJA ALDUK, MD, PHD, AND GERARD O’SULLIVAN, MD T venography (CTV) is not a particularly well- A B validated technique, with most data derived from anecdotal experience. For a variety of reasons, CTV has become the go-to imag- Cing modality for a quick and efficient answer to most venous problems. For example, we work in a trauma center with a large oncology population, and we have learned that oftentimes ultrasound simply doesn’t cut it, particularly in the context of intra-abdominal C D malignancy. Even in very experienced hands, things can be missed. CTV/contrast-enhanced CT provides multiple extra levels of information, including the presence or absence of inferior vena cava (IVC) filters; the condition of the IVC, renal veins, collaterals, and internal iliac veins; potential iliac vein compression or Figure 1. CTPA showing massive bilateral PE (A). Indirect CTV nutcracker syndromes; presence of pelvic varicosities; demonstrates acute IVC thrombosis (B), right external iliac as well as ovarian vein thrombosis and undiagnosed vein scarring due to previous DVT (C), and right common malignancy. femoral vein thrombosis (D). TECHNIQUE A C Indirect CTV Often combined with CT pulmonary angiography (CTPA) in the acute setting, indirect CTV is performed as a standard, nonoral, post–intravenous contrast- enhanced CT at approximately 120 to 150 seconds after injection of contrast, which is considerably later than portal venous phase.
    [Show full text]
  • Left Anterior Descending Coronary Artery Dissection During Ventricular Tachycardia Ablation – Case Report
    CASE REPORTS Left anterior descending coronary artery dissection during ventricular tachycardia ablation – case report KRESIMIR KORDIC, SIME MANOLA, IVAN ZELJKOVIC, IVICA BENKO, NIKOLA PAVLOVIC University Hospital Center Sisters of Charity, Department of Cardiology, Zagreb, Croatia Fascicular left ventricular tachycardia (VT) is the second most frequent idiopathic left VT in the setting of a structurally normal heart. Catheter ablation is curative in most patients with low complication rates. We report a case of ostial left anterior descending coronary artery (LAD) occlusion during fascicular ventricular tachycardia ablation. Dissection was the most likely cause of LAD obstruction. To the authors’ best knowledge, this is the first case reporting selective LAD dissection during electrophysiology study with no left main coronary artery (LMCA) affection. Key words: ventricular tachycardia, electrophysiology, radiofrequency catheter ablation, ST elevation myocardial infarction, percutaneous coronary intervention. INTRODUCTION An electrocardiogram following cardioversion showed normal sinus rhythm, without preexcitation Fascicular left ventricular tachycardia (VT) is or conduction abnormalities. There was no structural the second most frequent idiopathic left VT, after heart disease found on transthoracic echocardio- left ventricular outflow tract VT, occurring in the graphy. setting of a structurally normal heart [1]. An electrophysiology study was performed According to current ESC guidelines [2], using right femoral approach. During the tachy- catheter ablation is curative in most patients with cardia, His was activated after the ventricular VT without overt structural heart disease, with low activation and tachycardia could be entrained from complication rates (around 3%) [3]. Complications atrium and the ventricle. Based on these findings, include access site vascular complications, thrombo- the diagnosis of fascicular ventricular tachycardia embolism, atrioventricular block, myocardial per- was established.
    [Show full text]
  • Late Presentation of Constrictive Pericarditis After Limited Epicardial Ablation for Inappropriate Sinus Tachycardia
    Late presentation of constrictive pericarditis after limited epicardial ablation for inappropriate sinus tachycardia Adam Oesterle, MD,* Amita Singh, MD,* Husam Balkhy, MD,* Aliya N. Husain, MD,† Deborah Moyer, APN,* Roderick Tung, MD, FHRS,* Hemal M. Nayak, MD, FHRS* From the *Center for Arrhythmia Care, Heart and Vascular Center, The University of Chicago Medicine, Chicago, Illinois, and †Department of Pathology, The University of Chicago Medicine, Chicago, Illinois. Introduction Biosense-Webster Thermocool SF catheter (Diamond Bar, CA) was delivered in the endocardium. The ablation catheter The number of radiofrequency catheter ablation (RFA) and the angioplasty balloon were both removed and the procedures performed in the epicardial space is increasing.1 ablation catheter was inserted into the epicardial space Major acute complications (primarily pericardial bleeding) through the deflectable sheath, and 5 focal lesions were and delayed complications have been reported in 5% and 2% – delivered in the epicardium overlying the sinus node. At the of cases, respectively.2 4 To the best of our knowledge, a end of the procedure his heart rate decreased from 140 to 70 single case of constrictive pericarditis after multiple epicar- beats per minute. Kenalog (1 mg/kg) was injected into the dial ablations for ventricular tachycardia has been reported.5 pericardial space and the epicardial sheath was removed We describe a late presentation of constrictive pericarditis immediately after the procedure. The fluid was serous, that occurred after a single percutaneous epicardial without any evidence of bleeding, throughout the case. procedure with limited ablation for inappropriate sinus Twelve hours after the procedure, the patient developed tachycardia. pleuritic chest pain, treated with indomethacin, colchicine, and his home dose of aspirin 81 mg daily.
    [Show full text]
  • Electrophysiology with Artificial Intelligence Context and Challenge
    Envisioning Cardiac Electrophysiology with Artificial Intelligence Context and Challenge An estimated 17 million people die of cardiovascular As technology advances, various industries are adopting diseases (CVDs) every year worldwide. CVD covers technologies such as digital transformation, internet of hypertension, sudden cardiac arrest, arrhythmia/rhythm things (IoT), artificial intelligence (AI), nanotechnology, disturbance, stroke, peripheral artery disease, and many and so on within their product/service portfolio and the more. Arrhythmias constitute a major problem, wherein the medical device industry is no exception. the heart beats either too quickly or too slowly or with an irregular pattern [1]. This indicates the malfunctioning of The focus of this paper is to discuss software-based the hearth’s electrical system. Clinical symptoms including solutions incorporating AI within EP systems that can shortness of breath, dizziness, sudden weakness, fluttering improve overall system performance, improve the in the chest, lightheadedness, and fainting, are indications therapeutic outcomes, reduce procedural time, and assist for malfunctioning of the heart. the electrophysiologist during the procedure. An electrophysiology (EP) study is a test to assess a person’s cardiac electrical activity. It helps the electrophysiologist to diagnose and determine the precise location and nature of arryhthmias. The test is performed by inserting catheters and wired electrodes to measure electrical activity through blood vessels that enter the heart. The two main goals of a cardiac EP study are (1) to accurately diagnosis the conduction-disturbance mechanism and (2) to determine the best line of treatment for the conduction-disturbances. Treatment following a cardiac EP study could range from ablation therapy to pharmacologic to device to surgical intervention based on the nature of the findings.
    [Show full text]
  • 2Nd Quarter 2001 Medicare Part a Bulletin
    In This Issue... From the Intermediary Medical Director Medical Review Progressive Corrective Action ......................................................................... 3 General Information Medical Review Process Revision to Medical Record Requests ................................................ 5 General Coverage New CLIA Waived Tests ............................................................................................................. 8 Outpatient Hospital Services Correction to the Outpatient Services Fee Schedule ................................................................. 9 Skilled Nursing Facility Services Fee Schedule and Consolidated Billing for Skilled Nursing Facility (SNF) Services ............. 12 Fraud and Abuse Justice Recovers Record $1.5 Billion in Fraud Payments - Highest Ever for One Year Period ........................................................................................... 20 Bulletin Medical Policies Use of the American Medical Association’s (AMA’s) Current Procedural Terminology (CPT) Codes on Contractors’ Web Sites ................................................................................. 21 Outpatient Prospective Payment System January 2001 Update: Coding Information for Hospital Outpatient Prospective Payment System (OPPS) ......................................................................................................................... 93 he Medicare A Bulletin Providers Will Be Asked to Register Tshould be shared with all to Receive Medicare Bulletins and health care
    [Show full text]
  • About Electrophysiology Study of the Heart
    About Electrophysiology Study of the Heart What is an Electrophysiology Study? An ElectroPhysiology (EP) Study is a test that looks at the electrical system of your heart. An EP Study will show if you have a heart rhythm problem and what is causing the problem. Heart rhythm problems are known as arrhythmias. Why is an EP Study done? An EP Study is done when you have problems such as fainting, dizziness, heart palpitations or an abnormal heart beat. How does the heart work? To understand this procedure, you need to know how the heart’s electrical system works. The sinoatrial node (SA node) is a natural pacemaker. It starts the electrical signal that travels across the upper 2 chambers or atria of the heart to the atrioventricular node (AV node). The AV node transfers the electrical signal from the upper part of the heart to the lower 2 pumping chambers or ventricles. The bundle branches are specialized tissues that help send electrical impulses through the ventricles. This makes a normal heart beat called normal sinus rhythm. 01-77-0623-0 (Rev 03/2016) Page 1 of 4 What causes heart rhythm problems? Problems happen when the heart beats too fast or too slow. Some people are born with heart rhythm problems. Problems may also be caused by aging or heart disease. There are many different kinds of arrhythmias. Problems occur when the heart beats too fast or too slow. When this happens you may feel: dizzy faint short of breath very tired palpitations (pounding in your chest) The treatment for heart rhythm problems may include one or more of the following: medication a pacemaker a defibrillator ablation Who will do the EP Study? A doctor who specializes in ElectroPhysiology (EP) will do the procedure.
    [Show full text]
  • (MRA) and Magnetic Resonance Venography (MRV) Medical Policy
    Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) Medical Policy The content of this document is used by plans that do not utilize NIA review. Service: Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) PUM 250-0027-1712 Medical Policy Committee Approval 12/11/2020 Effective Date 01/01/2021 Prior Authorization Needed Yes Description: Magnetic Resonance Angiography (MRA) and Magnetic Resonance Venography (MRV) use Magnetic resonance imaging (MRI) technology to produce detailed 2-dimensional or 3- dimensional images of the vascular system and may be tailored to assess arteries or veins. It is often used for vascular conditions where other types of imaging are considered inferior or contraindicated, and to decrease risk of cumulative radiation exposure and often instead of invasive procedures. Indications of Coverage: A. MRA/MRV is considered medically necessary for the anatomical regions listed below when the specific indications or symptoms described are documented: 1. Head/Brain: a. Suspected intracranial aneurysm (ICA) or arteriovenous malformation (AVM). Any of the following: 1. Acute severe headache, severe exertional headache, or sudden onset of explosive headache, in individuals with signs / symptoms highly suggestive of a leaking/ruptured internal carotid artery or arteriovenous malformation. 2. Known subarachnoid hemorrhage or diagnosis of spontaneous intracerebral hemorrhage with concern for underlying vascular abnormality. 3. Suspected arteriovenous malformation (AVM) or dural AV fistula in an individual with prior indeterminate imaging study 4. Thunderclap headache with question of underlying vascular abnormality AND prior negative workup to include EITHER i. negative brain MRI, OR ii. Negative brain CT and negative lumbar puncture Page 1 of 15 5.
    [Show full text]
  • View Pdf Copy of Original Document
    Phenotype definition for the Vanderbilt Genome-Electronic Records project Identifying genetics determinants of normal QRS duration (QRSd) Patient population: • Patients with DNA whose first electrocardiogram (ECG) is designated as “normal” and lacking an exclusion criteria. • For this study, case and control are drawn from the same population and analyzed via continuous trait analysis. The only difference will be the QRSd. Hypothetical timeline for a single patient: Notes: • The study ECG is the first normal ECG. • The “Mildly abnormal” ECG cannot be abnormal by presence of heart disease. It can have abnormal rate, be recorded in the presence of Na-channel blocking meds, etc. For instance, a HR >100 is OK but not a bundle branch block. • Y duration = from first entry in the electronic medical record (EMR) until one month following normal ECG • Z duration = most recent clinic visit or problem list (if present) to one week following the normal ECG. Labs values, though, must be +/- 48h from the ECG time Criteria to be included in the analysis: Criteria Source/Method “Normal” ECG must be: • QRSd between 65-120ms ECG calculations • ECG designed as “NORMAL” ECG classification • Heart Rate between 50-100 ECG calculations • ECG Impression must not contain Natural Language Processing (NLP) on evidence of heart disease concepts (see ECG impression. Will exclude all but list below) negated terms (e.g., exclude those with possible, probable, or asserted bundle branch blocks). Should also exclude normalization negations like “LBBB no longer present.”
    [Show full text]