AMA Bookstore News, Jan. 17, 2012

Is there a cardiologist in the house? Or a cardiovascular coding specialist? Or anyone who has a need to know the most you can about this coding specialty? We have a book for you: CPT® Reference Guide for Cardiovascular Coding 2013. Hot off the press!

Written by the cardiovascular specialists at the American College of Cardiology Foundation and the CPT coding experts at the American Medical Association (AMA), this annual title publishes in late December and offers the most current coding and payment policy information. With this specialty coding resource you can select the most appropriate code for diagnostic and therapeutic radiological and cardiovascular procedures and services

Not since the 2011 edition have you had access to one of the most comprehensive glossaries for cardiovascular coding. But that all changes with the 2013 edition and the inclusion of more than 100 terms. Once again gain a quick and clear explanation of those terms you need to understand in order to properly code for cardiovascular services.

Each edition of this cardiology coding and reimbursement resource provides a complete overview of the heart structures, vessels, and conduction system, including cardiovascular basics and common ailments. However, the 2013 edition includes discussion of 49 more codes in such areas as E/M Services, the Cardiovascular subsections of Surgery and of Medicine, and Category III. Cardiovascular Coding 2013 also includes updated citations to CPT® Assistant, CPT® Changes, and Clinical Examples in Radiology, three authoritative AMA resources that offer in-depth explanations of specific procedures and services while improving your understanding of cardiovascular coding

Also gain that extra bit of insider detail by taking advantage of the more than 20 new and revised coding tips, such as the following:

Code 96374, Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug, may be reported in addition to code 93306, 93307, or 93308 for injection of contrast media for imaging during contrast echocardiography with resting echocardiography. The modifier 59 should be appended to code 96374. Based on payer requirements, the appropriate HCPCS Level II code should also be reported for the contrast material used.

February is Heart Awareness Month. Watch for the next AMA Bookstore News when we'll be featuring Cardiovascular Coding 2013 in our Product Showcase. You'll have the opportunity to save 30 percent.

We closed out 2012 with our newest HIPAA title written by Margret Amatayakul: Handbook for HIPAA-HITECH Security. Now we're excited to announce a new EHR title for 2013: A Guide to Achieving Meaningful Use: Leverage Your EHR to Redesign Workflows and Improve Outcomes.

The concept behind the Meaningful Use legislation is much more than an incentive program; it's a roadmap for clinical quality improvement and patient-caregiver engagement in the care decision process. Set to publish in July, A Guide to Achieving Meaningful Use operationalizes Stages 1 and 2 Meaningful Use requirements with early guidance on Stage 3.

A Guide to Achieving Meaningful Use answers the question “Are we redesigning workflow to meet a vendor's application design or are we redesigning workflow so that we can become a better practice providing the most effective patient care?”

While competitive books focus on meeting the Meaningful Use requirements, A Guide to Achieving Meaningful Use operationalizes the use of data in patient engagement, in business and clinical decisions, and in staff engagement in the data entry and quality improvement processes. Moreover, A Guide to Achieving Meaningful Use demonstrates how physicians can leverage meaningful use to strengthen their practice, not just meet the Meaningful Use criteria.

Primary care physician practices that want to know how to overcome barriers found in Stage 1 and plan for Stage 2 and 3 reporting should turn to this valuable resource. Those regional extension centers of quality improvement organizations can use A Guide to Achieving Meaningful Use to guide practices through Meaningful Use attestation. And health information management professionals and students will find the instructional nature of this title an asset to their continued understanding of EHRs.

Physician leaders, office managers, practice administrators, primary care physicians, quality improvement organizations (QIO), regional extension centers (RECs), community colleges and universities with HIM programs, and residents should consider adding this title to their collection of AMA books.

Read more, learn about the authors, and place your order on our Bookstore. For expanded author profiles, visit our Facebook page.

Do You Handle Medical Records?
All workforce members of a covered entity are required to receive privacy and security training. It's the law. Be compliant with HIPAA-HITECH regulations and receive online training with AMA HIPAA School.

Who should train? The list is long: physicians, nurses, other health care providers, security managers, coders, billers, health plans, health care clearinghouses, insurance companies, EHR vendors, health information management (HIM) and health information technology (HIT) instructors, HIM and HIT students, and all other business associates. If you handle a medical record, you need training.

Learn more, save with lower pricing, and enroll now.

A 26.5 percent cut to Medicare payments was prevented at the last minute on New Year's Day, but a similar cut will threaten again next year, thanks to the persisting sustainable growth rate (SGR) formula.

On Jan. 1, the US House of Representatives passed the American Taxpayer Relief Act, also known as the Middle Class Tax Relief Act, delaying the massive Medicare physician payment cut until Jan. 1, 2014. The US Senate previously approved the package with a vote of 89-8.

The package provides for the following actions:

• Extending current Medicare physician payment rates and the current Geographic Work Adjustment floor through Dec. 31, 2013.
• Deferring sequestration cuts for two months. This deferral includes the 2 percent cut in Medicare payments and larger cuts for other health programs, including research, public health initiatives and training of health care professionals.
• Creating a path to improve the provision of relevant and timely data to physicians. Such data is necessary for new delivery and payment models. The AMA helped frame these provisions in bipartisan negotiations with Senate Finance Committee staff.
• Allowing physicians to participate in clinical registries to meet Medicare quality reporting requirements. The AMA's negotiations with the Senate Finance Committee staff also helped frame this provision.
• Reauthorizing funding for the National Quality Forum for one year.

Learn to what extent these actions affect the Medicare resource-based relative value scale. Pre-order your copy of Medicare RBRVS: The Physicians' Guide 2013 today and save 25%.

The $25 billion cost of these changes was offset by an array of provisions. In accordance with the call of the AMA and many other prominent physician organizations, Congress did not adopt proposals to eliminate the increase in Medicaid payments for primary care services. However, payments for advanced imaging services will be reduced based on a change in assumptions regarding the utilization of equipment.

While the immediate crisis was averted, the cause of the Medicare cut threat remains to be addressed.

“This last-minute action on the part of Congress is a clear example of how the Medicare program is increasingly unreliable for physicians and patients,” AMA President Jeremy A. Lazarus, MD, said in a statement. “This patch temporarily alleviates the problem, but Congress' work is not complete; it has simply delayed this massive, unsustainable cut for one year. Over the next months, it must act to eliminate this ongoing problem once and for all.”

There may be situations that warrant the use of modifier 52, such as when extenuating circumstances require an inherently bilateral procedure to be performed on only one eye. Modifier 52 is appropriate when a service is reduced at the discretion of the physician or other qualified health care professional. The following are examples of procedures that are normally performed on both eyes.

92100 Serial tonometry (separate procedure) with multiple measurements of intraocular pressure over an extended time period with interpretation and report, same day (e.g., diurnal curve or medical treatment of acute elevation of intraocular pressure)

92225 Ophthalmoscopy, extended, with retinal drawing (e.g., for retinal detachment, melanoma), with interpretation and report; initial

92310 Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia

92314 Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia

92325 Modification of contact lens (separate procedure), with medical supervision of adaptation

Looking for more coding tips?  Check out CPT® Assistant Online.

Question: A patient has a chronic atrial lead in place that is no longer functioning and must be removed and a new lead placed. A transesophageal echocardiography (TEE) probe is placed prior to laser extraction of the lead to ensure there is no pericardial fluid that would indicate a perforation. How would the physician report the TEE probe placement and limited evaluation? How would the laser atrial lead extraction be reported?

Answer: Because there is no specific CPT code for a limited transesophageal echocardiography (TEE) study, code 93312, Echocardiography, transesophageal, real-time with image documentation (2D) (with or without M-mode recording); including probe placement, image acquisition, interpretation and report, may be reported with modifier 52, Reduced Services, appended when performed prior to the laser extraction of the lead. The appropriate code(s) for the pacemaker removal (33234, 33235) may be reported for the use of a laser sheath for transvenous lead removal via an endocardial approach.

Looking for more coding insight?  Check out CPT® Assistant Online.

AMA Coding Online products let you work through coding and compliance transactions with confidence. Get the valuable, exclusive content from the CPT® experts for 2013—right at your fingertips.
Products include:

CodeManager® Online: Elite—the AMA's premier coding and payment tool. Features include:

•  
  • Instant access to the latest CPT®, ICD-9-CM Volumes 1, 2 and 3, HCPCS Level II code sets and Medicare data—the online version mirrors the book layout to promote ease of use!
  • Monthly updates to keep your billing practices accurate
  • Available in Elite, Professional and Standard versions

CPT® Assistant Online—trusted for authoritative coding guidance. Monthly updates and searchable content dating back to 1990 gives you the data you need to appeal insurance denials, validate coding to auditors, train staff and answer day-to-day coding questions.

CPT® Changes Online—research critical code changes dating back to 2000. Based on the criteria you set, this invaluable library instantly searches each edition of the AMA's best-selling CPT® Changes: An Insider's View for the official AMA interpretations and rationales for every new, revised and deleted CPT code and guideline change.

RBRVS DataManager Online—accurately calculate and report claims based on the Medicare Physician Payment Schedule. Includes more than 3,200 AMA-exclusive CPT vignettes with pre-/intra-/and post-service data, direct practice expense inputs for virtually every CPT code, and more.

Clinical Examples in Radiology Online—the easiest way radiology coders can improve claims reporting and payment accuracy. Co-published by the AMA and the American College of Radiology, this newsletter was developed to help coding professionals understand the practical application of CPT codes with regard to radiology coding.

Start your comprehensive suite today!

If you haven't had a chance, check us out on Facebook. There in our notes section you can read more about AMA's expert authors and click on links to the books they've published with the AMA. And once you're there, don't forget to like us.

Ask Questions
Do you have a question for one of our AMA authors? Ask by sending us an email with a subject line of "Question for Insider's View." Throughout this year, we'll select from the questions received and publish our authors' answers in the "Insider's View" section of AMA Bookstore News. If we select your question, you'll receive a $25 coupon code that can be used on products purchased through our online bookstore.

Don't hesitate. Ask.

Author Webinar on EHR
AMA author Carolyn Hartley will present an EHR-related Webinar through her company Physicians EHR. She will be joined by litigation attorney Kerrie Wagoner Boyle to discuss the “Fragile State of the Hybrid Chart.” Carolyn will also speak about her book EHR Implementation: A Step-by-Step Guide for the Medical Practice, second edition, a title published by the AMA. Learn more about this Jan. 29 Webinar.

Join the AMA this year for more ICD-10-CM Workshops. More workshops will occur in Chicago during the first half of 2013, one will coincide with our annual Symposium in November, and five more will take place in conjunction with our annual CPT Changes workshops in December.

Content will continue to touch on preparation for and implementation of ICD-10-CM but will focus more on proper diagnostic coding. Because of the emphasis on coding, attendees will receive a free copy of the ICD-10-CM draft codebook as well as other informational resources. Watch for more details coming soon.

Did you miss our Workshops in 2012?
A condensed, four-hour Webinar of both the CPT Changes 2013 and ICD-10-CM Workshops that occurred in 2012 are now available as recorded Webinars. When you purchase access to one the Webinars, you will also gain access to a PDF version of the official Attendee Guide from the Workshop as well as to CEU certificates. Order a Webinar now.

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