Cardiology Billing and Coding Updates: 2021

Cardiology billing services are designed to help you maximize collections by meeting government regulations and private payer requirements. Since 2016 when ICD-10 became the official code set for the United States we saw several changes to cardiovascular diagnosis codes. No more hypertension table, we now have a new way to code hypertension (I10 – I15). We have new diagnosis codes for STEMI/NSTEMI (I21 – I22.9), saw a change with the heart failure diagnosis codes (I50 – I50.9), and new for 2018 was the myocardial infarction codes (I21.4 – I21.A9) broken down by types. With these specific codes, we encourage providers, staff, and coders to help everyone code as specifically as possible. Accurate documentation allows a better understanding of the care for the patient and allows a better avenue for the collection of data.

CMS has released the 2019 coding guidelines for ICD-10. It is a good idea to review the guidelines each year to see if any changes were made. Although there are more than 450 code changes in the ICD-10-CM updates for 2019, there were minimal additions and revisions that affect cardiology. However, it is essential to familiarize yourself with the few changes relevant to the cardiology specialty.

Cerebral Infarction for Cardiology

New codes were added to the Cerebral infarction category (category I63), including:

  • I63.81 – Other cerebral infarction due to occlusion or stenosis of the small artery (lacunar infarction is also included under this code)
  • I63.89 – Other cerebral infarction

When applicable, you may need to report an additional code (R29.7-) indicating the National Institutes of Health Stroke Scale for the patient.

New Subcategory Added: I67

Other cerebrovascular diseases (category I67) now have a new subcategory for hereditary cerebrovascular diseases. New codes in this subcategory include:

  • I67.850 – Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL is also included with this diagnosis)
  • I67.858 – Other types of hereditary cerebrovascular disease

With this new subcategory, there’s a new “code also” note instructing the reporting of associated diagnoses, such as vascular dementia, recurrent seizures, and cerebral infarction.

Other Code Revisions

  • 197.64 – Postproc seroma of a circ system org fola a circ sys procedure
  • 122.8 – Subsequent posterior transmural myocardial infarction (Q wave) (acute)
  • T81.11 – Postprocedural cardiogenic shock
  • T46.4X – Angiotensin-converting-enzyme inhibitors

Cardiology practices, like other specialty practices, offer a variety of different services, including blood work, invasive procedures, and other interventions to patients in a variety of different settings. The charges for services are dealt with differently depending on where the services were provided – in same-day surgery centers, in a hospital setting, or in the doctor’s office.

Accurate Cardiology billing and coding require excellent working knowledge of current coding rules, cardiology-specific codes, and compliance standards. Even small mistakes in cardiology billing and coding can result in denials that lower your practice revenue. Medical Billers and Coders (MBC) can assist you in remaining up to date with Cardiology medical coding and billing. To know more about our services contact us at 888-357-3226/