Cardiology|Vascular - Articles

Medical ID Theft
August 16th, 2019 - Namas
Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...
The OIG Work Plan: What Is It and Why Should I Care?
August 9th, 2019 - Namas
The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...
The Facts of Critical Care
July 19th, 2019 - Namas
Critical care services remain to not only be an area of confusion for providers, coders, and auditors, but also a constant target for the carriers for audit. We can sit back and look at critical care and think of all of the ways the code descriptor and/or use could be ...
5 Ways to Minimize HIPAA Liabilities
July 12th, 2019 - BC Advantage
Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...
How to Properly Report Monitoring Patients Taking Blood-thinning Medications
June 18th, 2019 - Wyn Staheli, Director of Research
Codes 93792 and 93792, which were added effective January 1, 2019, have specific guidelines that need to be followed. This article provides some guidance and tips on properly reporting these services.
Diagnosis Coding for Cardiology
November 8th, 2018 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Diseases of the Circulatory system are found in Chapter 9 and reported with I00 through I99 according to the following sections: Acute rheumatic fever (I00-I02)Chronic rheumatic heart diseases (I05-I09)Hypertensive diseases (I10-I16)Ischemic heart diseases (I20-I25)Pulmonary heart disease and diseases of pulmonary circulation (I26-I28)Other forms of heart disease (I30-I52)Cerebrovascular diseases (I60-I69)Diseases of arteries, ...
HCC - Acceptable Provider Interpretation for Diagnostic Testing
October 1st, 2018 - Wyn Staheli, Director of Research
The following table is taken from the Contract-Level Risk Adjustment Data Validation Medical Record Reviewer Guidance dated 2017-09-27 (see References). It is a listing of acceptable provider interpretation of diagnostic testing. Acceptable Examples include: Cardiology and Vascular Surgeons Echocardiogram (including Doppler, Duplex, Color flow of the heart vessels) EKG (electrocardiogram) – Stress test, Cardiac ...
Home Oxygen Therapy -- CMN for Oxygen
June 14th, 2018 - Raquel Shumway
The Certificate of Medical Necessity (CMN) for Oxygen is a required form that helps to document the medical necessity for oxygen therapy. It also documents other coverage criteria for the oxygen use. For payment on a home oxygen claim, the information in the supplier’s records or the patient’s medical record must be substantiated with the information in the CMN.
Preventive Medicine: Cardiovascular Disease Screening Tests
May 9th, 2018 - Find-A-Code™
Preventive Medicine Topics Page Cardiovascular Disease Screening Tests Procedure Codes 80061: Lipid panel. This panel must include the following: Cholesterol, serum, total Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) Triglycerides 82465: Cholesterol, serum, total 83718: Lipoprotein, direct measurement, high density cholesterol (HDL cholesterol) 84478: Triglycerides 83721: Lipoprotein, direct measurement; LDL cholesterol 83719: Lipoprotein, ...
Medicare Changes Requirements for Implantable Cardioverter Defibrillators (ICDs)
February 26th, 2018 - Wyn Staheli, Director of Research
Whenever there is a high-cost item, CMS has historically evaluated usage to determine appropriateness of billing and this is another example. A Decision Memo was released on February 15, 2018 which included the following changes: Changes to who qualifies for a device and the required waiting periods Patient registry no longer required Cardiac magnetic resonance ...
Non-Coronary Vascular Stents: Mesenteric Vessels
January 29th, 2018 - Find-A-Code
The following information is according to Novitas Solutions L35084. Mesenteric vessels: This includes Acute mesenteric ischemia Chronic mesenteric ischemia Mesenteric thrombosis Dissection or any other vascular insufficiency resulting in gastrointestinal symptoms Stenting of the mesenteric vessels is covered only when angioplasty of the vessels would not suffice and after the patient has had a thorough medical evaluation and management of symptoms, and for whom surgical intervention is the likely ...
Non-Coronary Vascular Stents: Brachiocephalic arteries
January 16th, 2018 - Find-A-Code
According to Novitas Solutions L35084 Brachiocephalic arteries (including subclavian, except carotid bifurcation): Stenting may be indicated for treatment of flow-limiting stenosis resulting in conditions such as: Subclavian steal syndrome Upper extremity claudication Ischemic rest pain of the arm and hand Non-healing tissue ulceration Focal gangrene. CPT codes: 37236 37237 ICD-10-CM codes: G45.8 - Other transient cerebral ischemic attacks and related syndromes Unspecified atherosclerosis of native arteries of extremities I70.201 - right leg I70.202 - left leg I70.203 - ...
Non-Coronary Vascular Stents: Lower extremity arteries (abdominal aorta, iliac, superficial femoral and infropoliteal arteries)
January 16th, 2018 - Find-A-Code
The following information is according to Novitas Solutions L35084. Lower extremity arteries (abdominal aorta, iliac, superficial femoral and infrapopliteal arteries): This includes: Lifestyle-limiting claudication Focal hemodynamically significant lesion Ischemic rest pain Non-healing tissue ulceration Focal gangrene Stent placement in infrapopliteal vessels is not expected to be often indicated and in those cases the rationale for stent placement must be explained in the record. CPT codes: 37221 37223 37226 37227 37230 37231 37234 37235 ICD-10-CM codes: Type 1 diabetes mellitus E10.51 - with diabetic peripheral angiopathy without gangrene E10.59 - with other circulatory ...
Non-Coronary Vascular Stents: Renal artery
January 16th, 2018 - Find-A-Code
The following information is according to Novitas Solutions L35084. Renal artery: Stenting may be indicated for renal artery stenosis causing renovascular hypertension (see below) or renal insufficiency as well as post-transplant renal artery stenosis, arterial aneurysm or dissection. Renal artery angioplasty with or without stenting is covered for renal artery stenosis manifested by at least one of the following conditions: Recurrent (“flash”) pulmonary edema without cardiac ...
Preventative Services: Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)
January 11th, 2018 - Find-A-Code
The following information from the Medicare Learning Network provides guidance on Ultrasound Screening for Abdominal Aortic Aneurysm (AAA)
Non-Coronary Vascular Stents: Inferior vena cava and iliofemoral veins
January 9th, 2018 - Find-A-Code
The following information is according to Novitas Solutions, L35084. Inferior vena cava and iliofemoral veins: This includes vena cava and iliofemoral venous occlusions and stenosis due to the following Post-radiation venous stenosis Congenital stenoses or webs Extrinsic venous compression (May-Thurner syndrome) Thrombophlebitis and symptomatic post-traumatic venous stenosis. CPT codes: 37238 37239 ICD-10-CM codes: Phlebitis and thrombophlebitis I80.10 - of unspecified femoral vein I80.11 - of right femoral vein I80.12 - of left femoral vein I80.13 - of femoral vein, bilateral I80.211 - of right iliac vein I80.212 - of left iliac vein I80.213 - of iliac vein, bilateral I80.219 - of unspecified iliac vein I80.8 - of ...
New and Deleted Angioplasty Codes for 2017
January 23rd, 2017 - Chris Woolstenhulme, CPC, CMRS
The following codes have been Deleted as of January 01, 2017 35450   Transluminal balloon angioplasty, open; renal or other visceral artery 35452   Transluminal balloon angioplasty, open; aortic 35458   Transluminal balloon angioplasty, open; brachiocephalic trunk or branches, each vessel 35460   Transluminal balloon angioplasty, open; venous 35471   Transluminal balloon angioplasty, percutaneous; renal or visceral artery 35472   Transluminal balloon angioplasty, percutaneous; aortic 35475   Transluminal balloon angioplasty, percutaneous; ...

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