ATCR.book Page 1 M onday, N ovem ber 21, 2011 2:11 PM Coding Companion for Cardiology/Cardiothoracic/ Vascular Surgery A comprehensive illustrated guide to coding and reimbursement 2013 ATCR.book Page i M onday, N ovem ber 21, 2011 2:11 PM Contents Getting Started with Coding Companion .............................i Diaphragm ......................................................................574 Breast ..................................................................................1 Esophagus .......................................................................577 General Musculoskeletal ......................................................2 Abdomen ........................................................................624 Neck and Thorax .................................................................4 Thyroid Gland .................................................................629 Larynx ...............................................................................24 Parathyroid......................................................................630 Trachea and Bronchi ..........................................................28 Nervous System...............................................................633 Lungs and Pleura ...............................................................58 Medicine .........................................................................640 Heart and Pericardium .....................................................132 Appendix.........................................................................702 Arteries and Veins ............................................................288 Evaluation and Management ...........................................757 Lymph Nodes ..................................................................567 Index...............................................................................777 Mediastinum ...................................................................570 CPT only © 2011 American Medical Association. All Rights Reserved. © 2011 Optum Coding Companion for Cardiology/Cardiothoracic/Vascular Surgery Contents (Potts-Smith type operation), for flow to one stenosis. Narrowing or constriction of a 33750 lung (classical Glenn procedure), see 33766. passage. For superior vena cava to pulmonary artery 33750 Shunt; subclavian to pulmonary artery tetralogy of Fallot. Specific combination (Blalock-Taussig type operation) for flow to both lungs (bidirectional Glenn procedure), see 33767. of congenital cardiac defects: obstruction of the right ventricular outflow tract with ICD-9-CM Procedural pulmonary stenosis, interventricular septal defect, malposition of the aorta, overriding 39.0 Systemic to pulmonary artery shunt the interventricular septum and receiving 39.61 Extracorporeal circulation auxiliary to blood from both the venous and arterial open heart surgery systems, and enlargement of the right ventricle. Anesthesia tricuspid atresia. Congenital absence of 33750 00560 the valve that may occur with other defects, such as atrial septal defect, pulmonary atresia, ICD-9-CM Diagnostic and transposition of great vessels. 424.3 Pulmonary valve disorders Waterston procedure. Type of 745.2 Tetralogy of Fallot aortopulmonary shunting done to increase 746.01 Congenital atresia of pulmonary valve pulmonary blood flow where the ascending 746.02 Congenital stenosis of pulmonary aorta is anastomosed to the right pulmonary valve artery. 746.09 Other congenital anomalies of pulmonary valve CCI Version 17.3 0213T, 0216T, 0228T, 0230T, 32100, 32422, 746.1 Congenital tricuspid atresia and 32551, 33140-33141, 33210-33211, stenosis 33254-33256, 33310-33315, 36000, 746.2 Ebstein's anomaly 36400-36410, 36420-36430, 36440, 36600, 746.9 Unspecified congenital anomaly of 36640, 37202, 39000-39010, 43752, Heart Explanation heart 51701-51703, 62310-62319, 64400-64435, In its unmodified form, this operation involves 64445-64450, 64479, 64483, 64490, 64493, dividing the left subclavian artery, tying off Terms To Know 64505-64530, 69990, 93000-93010, and the end of the artery going to the arm, and 93040-93042, 93318, 94002, 94200, 94250, atresia. Congenital closure or absence of a 94680-94690, 94770, 95812-95816, 95819, creating a connection between the end of this Pericardium artery coming from the heart and the side of tubular organ or an opening to the body 95822, 95829, 95955, 96360, 96365, 96372, the pulmonary artery. The difficulty with this surface. 96374-96376, 99148-99149, 99150 Note: These CCI edits are used for Medicare. operation is making the connection to the Blalock-Taussig procedure. Anastomosis pulmonary artery exactly the right size to Other payers may reimburse on codes listed of the left subclavian artery to the left supply adequate, but not excessive blood flow above. pulmonary artery or the right subclavian artery to the lungs. Instead, a modified version of to the right pulmonary artery in order to shunt the operation is usually performed. The artery Medicare Edits some of the blood flow from the systemic to to the arm is not divided. Instead, one end of the pulmonary circulation. Fac Non-Fac a 3 mm to 5 mm diameter tube of Gortex is RVU RVU FUD Status sewn to the side of the artery to the arm and cardiopulmonary bypass. Venous blood 33750 41.7 41.7 90 A the other end is sewn to the side of the is diverted to a heart-lung machine, which pulmonary artery. The size of the tube mechanically pumps and oxygenates the MUE Modifiers 33750 1 51 N/A 62* 80 determines the amount of blood flow to the blood temporarily so the heart can be * with documentation lungs. Cardiopulmonary bypass is not bypassed while an open procedure on the required. The ductus arteriosus (a connection heart or coronary arteries is performed. During Medicare References: None between the aorta and pulmonary artery that bypass, the lungs are deflated and immobile. has been supplying blood to the lungs, but usually closes at birth) is tied off. congenital. Present at birth, occurring through heredity or an influence during Coding Tips gestation up to the moment of birth. This procedure is sometimes performed in Potts-Smith-Gibson procedure. conjunction with 33684. When ligation and Side-to-side anastomosis of the aorta and left takedown of systemic-to-pulmonary artery pulmonary artery creating a shunt that shunt is performed in conjunction with this enlarges as the child grows. procedure, it should be reported separately; see 33924. Do not append modifier 63 to shunt. Surgically created passage between 33750 as the description or nature of the blood vessels or other natural passages, such procedure includes infants up to 4 kg. For as an arteriovenous anastomosis, to divert or shunt, ascending aorta to pulmonary artery bypass blood flow from the normal channel. (Waterston type operation), see 33755. For descending aorta to pulmonary artery CPT only © 2011 American Medical Association. All Rights Reserved. © 2011 Optum Coding Companion for Cardiology/Cardiothoracic Surgery/Vascular Surgery Heart and Pericardium — 239 maintain blood pressure. Report 36455 if the child 36400 36415-36416 is other than a newborn. 36400 Venipuncture, younger than age 3 years, 36415 Collection of venous blood by necessitating physician's skill, not to be venipuncture 36510 used for routine venipuncture; femoral or 36416 Collection of capillary blood specimen (eg, 36510 Catheterization of umbilical vein for jugular vein finger, heel, ear stick) diagnosis or therapy, newborn Explanation Explanation Explanation A needle is inserted through the skin to puncture A needle is inserted into the skin over a vein to The physician catheterizes the umbilical vein for the femoral or jugular vein of a child younger than puncture the blood vessel and withdraw blood for diagnostic or therapeutic purposes. The physician age 3. The needle is inserted into the vein and used venous collection in 36415. In 36416, a prick is cleanses the umbilical cord stump and locates the for the withdrawal of blood for diagnostic study or made into the finger, heel, or ear and capillary blood umbilical vein. A catheter is inserted in the vein for for the therapeutic infusion of intravenous that pools at the puncture site is collected in a reasons including blood sampling or administering medication. A soft flexible catheter may be placed pipette. In either case, the blood is used for medication. for prolonged therapy. Once the procedure is diagnostic study and no catheter is placed. complete, the needle or catheter is withdrawn and pressure is applied over the puncture site to control 36660 bleeding. Use this code for venipuncture 36420-36425 36660 Catheterization, umbilical artery, newborn, necessitating a physician's skill, not when routine 36420 Venipuncture, cutdown; younger than age for diagnosis or therapy venipuncture is performed. 1 year 36425 age 1 or over Explanation The physician catheterizes an umbilical artery in a 36405-36406 newborn for diagnostic or therapeutic purposes. 36405 Explanation Venipuncture, younger than age 3 years, The physician prepares the umbilical artery and necessitating physician's skill, not to be The physician makes an incision in the skin directly passes a catheter sheath inside the lumen for arterial used for routine venipuncture; scalp vein over the vessel and dissects the area surrounding access. The catheter is attached to a pressure line 36406 other vein the vein. A needle is passed into the vein for the that maintains patency of the arterial lumen. The withdrawal of blood or for the infusion