Use These Cardiology Category I Codes in Place of ‘T’ Codes in 2016

Posted on 30 Oct, 2015 |comments_icon 7|By Chris Boucher

Keep an eye on Medicare, other payers for reimbursement news.

If your cardiology practice has been hoping for a better chance at payment for a couple of currently “experimental” procedures, CPT® has good news.

The skinny: The 2016 CPT® manual deletes 0262T (Implantation of catheter-delivered prosthetic pulmonary valve, endovascular approach) and 0311T (Non-invasive calculation and analysis of central arterial pressure waveforms with interpretation and report) and replaces them with a pair of category I codes.

Read on for a rundown of the reasons these code changes are such good news.

Category I Bump-Up Increases Reimbursement Chances

In 2016, report 33477 (Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed) instead of 0262T. The new code number places the service in with other pulmonary valve surgical procedures.

Also, report 93050 (Arterial pressure waveform analysis for assessment of central arterial pressures, includes obtaining waveform[s], digitization and application of nonlinear mathematical transformations to determine central arterial pressures and augmentation index, with interpretation and report, upper extremity artery, non-invasive) in place of 0311T. Experts expected this code change, as waveform analysis not only indicates central systolic and diastolic pressure, it also determines the influence of pulse wave reflection on the central pressure waveform. It can serve as a useful adjunct to brachial blood pressure measurements in initiating and monitoring hypertensive treatment and other factors.

Benefit: Whenever CPT® moves a code from category III to category I, it’s a big deal in the coding world. Category III codes represent procedures that CPT® deems “experimental;” thusly, cardiology practices have a tough time getting paid for category III codes. If the code is “upped” to category I status, however, the procedure is no longer considered experimental.

As Advance Healthcare Network reports on its Website, category I codes are for “procedures that are consistent with contemporary medical practice and are widely performed,” while category III codes represent “temporary codes for emerging technology, services and procedures.”

Payment for these procedures might still be spotty, especially in 2016. The change is great news, however, as it means CPT® is trying to get 33477 and 93050 into the procedural mainstream — which can only help payment possibilities.


Chris Boucher

Chris Boucher has nearly 10 years of experience writing various newsletters and other products for The Coding Institute. His blog will cover several areas of coding and compliance, including CPT® coding, modifiers, HIPAA compliance and ICD-10 coding.

More from this author

View More

7 thoughts on “Use These Cardiology Category I Codes in Place of ‘T’ Codes in 2016

  1. I am glad for writing to let you be aware of what a beneficial discovery my friend’s child developed reading your site. She picked up so many details, including how it is like to have a very effective coaching heart to have the others very easily know just exactly specified impossible subject matter. You undoubtedly exceeded visitors’ expectations. Thank you for providing the powerful, healthy, revealing as well as unique tips on that topic to Kate.

  2. I have to convey my affection for your kindness in support of people who require help on your niche. Your special commitment to passing the solution all-around had become surprisingly useful and have made some individuals much like me to attain their targets. Your amazing insightful tips and hints entails a great deal to me and further more to my mates. Thank you; from all of us.

  3. I actually wanted to jot down a brief word so as to thank you for these stunning items you are giving here. My extended internet lookup has finally been paid with excellent know-how to share with my good friends. I ‘d suppose that we site visitors are undeniably lucky to exist in a wonderful place with so many perfect professionals with great tactics. I feel quite grateful to have come across your entire website page and look forward to some more brilliant times reading here. Thanks a lot once again for everything.

  4. Thank you a lot for providing individuals with such a nice opportunity to read critical reviews from this site. It’s always very useful and as well , stuffed with amusement for me and my office peers to visit your website particularly three times in one week to see the new guidance you have. And of course, I am also at all times astounded with the unbelievable opinions served by you. Some 3 areas in this post are in reality the simplest we have had.

  5. Thank you so much for providing individuals with an exceptionally pleasant chance to read in detail from this web site. It really is very brilliant and as well , packed with a lot of fun for me and my office acquaintances to visit your website at least three times in 7 days to study the fresh issues you will have. Not to mention, I’m so at all times fascinated for the breathtaking tricks you give. Selected 4 areas on this page are in truth the most suitable we have all had.

Leave a Reply

Newsletter Signup