Medical Coding Resources - Angiography

A medical coder always needs to have his knowledge updated and need to continue his education throughout the career. As we know, every year on Oct 1, the ICD-9 CM gets updated and on Jan 1 of every year CPT and HCPCS gets updated.

All Medical coders need to follow Coding Clinics and CPT Assistants where you can have your knowledge updated.

The coding edge magazine from AAPC is also a very good magazine to follow. The journals from both the AHIMA and AAPC are valuable and knowledge gaining.

There are many blogs and forums over net where you can be part of them and share your knowledge with them. Keep reading articles on coding whenever you have time.

Some of the coding resources:

http://health-information.advanceweb.com/

http://www.justcoding.com/

http://www.hcpro.com/

http://www.ahima.org/coding/coding_resources.asp

http://www.cms.hhs.gov/

http://www.aapc.com/

http://www.pharma-lexicon.com/

http://www.coderyte.com/

http://www.zhealthpublishing.com/

http://www.stedmans.com/

Medical Coding Schools

Medical Coding is assigning numeric values for the procedures and/or diagnoses documented in the medical record. For being a medical coder, you need to undergo training and then need to get certification, which makes you a qualified coder, which inturn increases your chances of getting a better job. 

There are many online coding scools and classroom schools where you can undergo training. The training can be completed in 3-6 months period of time. For Certification, please check our post on coding certifications.

Here are the list of the schools which give medical coding training.

http://www.andrewsschool.com/

http://www.codingcert.com/

http://online.allenschool.edu/

http://www.earnmydegree.com/online-education/health-

care/medical-billing-and-coding.html

http://www.lincolnonline.edu/programs/online-associate-degrees/online-medical-coding-and-billing

http://www.codemedschool.com/

Tags: Medical coding training, medical coding courses, medical coding colleges, medical coding job, medical coding specialist.

Angiography

Indications and Limitations for Angiography

Angiograms of the individual cardiac chambers will be reimbursed based on medical necessity. Coding must utilize the most all-inclusive procedure description. Each procedure may be reimbursed only once regardless of the number of views or actual pictures taken.

Aortography is reimbursable only for diagnoses of aortic root disease, valvular heart disease or congenital heart disease. It is not reimbursable for atherosclerotic heart disease. Angiograms to visualize the coronary ostia are included as part of coronary angiography. A diagnosis of "rule out (valvular lesion)" is not reimbursable.

Coronary angiography includes arteriograms of all the coronary arteries and their branches, regardless of the number of vessels visualized. Coronary angiography includes angiograms done with the administration of medications for diagnostic purposes (e.g., ergonovine, nitroglycerine) as part of the procedure. 

The procedure may be reimbursed only once regardless of the number of views, films or whether medications were administered. Replacement and repositioning of catheters are considered as part of the procedure, and are not reimbursable separately. The selective injection procedures may be performed without a formal left heart catheterization.

Angioplasty/Stent Placement/Atherectomy

Indications and Limitations for Angioplasty/Stent Placement/Atherectomy

The interventional procedures - percutaneous transluminal angioplasty, coronary stent placement and atherectomy are described under the interventional cardiology policy. These are separately reimbursable procedures.

Diagnostic cardiac catheterization with coronary angiography performed prior to an interventional procedure is reimbursable whether done on the same day or on a previous day, when used as a diagnostic tool to evaluate the need for the intervention, but only once prior to the interventional procedure. 

When the interventional procedure and cardiac catheterization with angiography are done on the same day, the multiple surgery pricing will apply (payment in full for the higher of two procedures and 50% for the second, etc.). 

Angiography to evaluate results of the interventional procedure and to guide the catheter(s) (to assist with the interventional procedure) is considered incident to the procedure and is not separately reimbursable.

General Limitations

The completion of the diagnostic cardiac catheterization and the interventional procedure on the same day is increasingly the standard of practice. While there may be legitimate reasons for delaying the interventional procedure (e.g., transfer from a community hospital to a tertiary center), Medicare strongly discourages the separation of these procedures to circumvent the multiple surgery pricing.

Cardiac catheterization requires personal (in person) supervision of its performance by a physician. When performed in a teaching setting, the teaching physician must be present with the resident throughout the procedure. The performance by the resident alone would not establish a basis for fee schedule payment for such services.

Vascular closure of the puncture site is an inherent part of all procedures for arterial access. As such, it is included in the arterial access codes for all angiographic and catheterization procedures, and may not be billed separately.

Extra Cardiac Angiography performed with Cardiac Catheterization.

Extra Cardiac Angiography is sometimes reported with cardiac catheterization. These services include interrogation of the abdominal plus iliofemoral artery, abdominal aorta, carotid and renal arteries.

However, such services are generally not indicated and will be denied unless there are specific conditions that warrant selective investigation. Examples of specific clinical syndromes are: subclavian steal syndrome, TIA (transient ischemic attack), renal artery stenosis, hypertensive patients with pulmonary edema and renal failure.

These extra angiographic services must be specifically requested by the treating physician.

Other Non-covered Procedures During Catheterization

• Prophylactic insertion of temporary transvenous pacemaker

• Assistant at surgery

•Right heart catheterization for the purpose of inserting a temporary pacemaker or performing electrophysiologic studies

• Standby anesthesia or surgeon during angioplasty

• Repositioning and replacement of catheters

• Administration of medications during catheterization

• Percutaneous vascular closure (e.g., Perclose)

• Anesthesia