UNIT 5

DISEASESCARDIOVASCULAR SYSTEM

& ANESTHESIA CODING

HI250 Medical Coding II

Unit 5 Assignments – Due 4/26/11 In 3-2-1 Code It!, Green textbook:

Re-read coding guidelines for cardiovascular coding on pp. 141-143 of Green

Read Green, pp. 508-536 on CPT coding of cardiovascular procedures

Read Green, pp. 378-408 on anesthesia coding

Participate in the discussion (graded)

Complete the practice exercises

Complete the Learning Activities (graded) Green, pp. 547-550 Coding Practice, 21-40 (odd numbers) Green, pp. 411-416, #23, 24, 26 and 29 Green workbook, p. 120 #4 Green workbook, p. 121 #11, #12

Learning Objectives

Diseases of the Cardiovascular System

Cardiovascular CPT Coding

Anesthesia Coding

Coding Practice - IPCase006 (WB 430-461)

1. Does Sally smoke?2. Sally had chest x-rays – what diagnosis did the

radiologist give Sally?3. Sally had blood chemistry tests done on 7/1.

Were any of these abnormal? If so, which?4. The diagnosis of arteriosclerotic heart disease is

mentioned on Sally’s face sheet. Where in the body of this chart is that diagnosis supported?

5. Are there any other medical problems that Sally has that are not mentioned on the face sheet?

Coding Practice - IPCase006

1. How would you code this chart ?

(include the proper sequencing)

1. Which of her conditions, if any, were POA?

2. What MS-DRG does this case fall into?

ICD-9-CM Cardiovascular Coding Guidelines

Hypertension

CVA

Postoperative cerebrovascular accident

Late effects of cerebrovascular disease

AMI

CPT Cardiovascular Guidelines

Selective Vascular CatheterizationHeart and Pericardium

Pericardium Cardiac Tumor Transmyocardial Revascularization Pacemaker or Pacing Cardioverter-Defibrillator Electrophysiologic Operative Procedures Patient-Activated Event Recorder Wounds of the Heart and Great Vessels Cardiac Valves and Other Valvular Procedures Coronary Artery Anomalies

CPT Cardiovascular Guidelines (continued)

Heart and Pericardium (continued) Endoscopy Coronary Artery Bypass Graft (CABG) Procedures Coronary Endarterectomy Single Ventricle and Other Complex Cardiac

Anomalies Congenital Heart Defects Thoracic Aortic Aneurysm Pulmonary Artery Heart/Lung Transplantation Cardiac Assist

CPT Cardiovascular Guidelines (continued)

Arteries and Veins Embolectomy/Thrombectomy Venous Reconstruction Endovascular and Direct (Open) Repair of Aneurysms Thromboendarterectomy Angioscopy Transluminal Angioplasty Transluminal Atherectomy Bypass Graft Composite Graft Adjuvant Techniques

CPT Cardiovascular Guidelines (continued)

Arteries and Veins (continued) Arterial Transposition Excision, Exploration, Repair, Revision Vascular Injection Procedures Central Venous Access Procedures Arterial Intraosseous Hemodialysis Access, Intervascular Cannulation for

Extracorporeal Circulation, or Shunt Insertion Portal Decompression Procedures Transcatheter Procedures Carotid Stenting Intravascular Ultrasound Services Ligation

CPT Anesthesia Overview

Types of Anesthesia General anesthesia Local anesthesia Regional anesthesia

Anesthesia Guidelines

Reporting Codes for Monitoring or Providing Other

Services

Emergency Endotracheal Tube Intubation

Central Venous Access Devices

Intra-Arterial Lines

Drug Administration Codes

Anesthesia Guidelines (Continued)

Anesthesia ModifiersHCPCS Level II Anesthesia ModifiersPhysical Status ModifiersCPT ModifiersTime ReportingPhysician’s ServicesMaterials Supplied by PhysicianSeparate or Multiple ProceduresSeparate ReportQualifying Circumstances

Anesthesia Subsections

Head Knee and Popliteal Area

Neck Lower Leg

Thorax Shoulder and Axilla

Intrathoracic Upper Arm and Elbow

Spine and Spinal Cord Forearm, Wrist and Hand

Upper Abdomen Radiological Procedures

Lower Abdomen Burn Excisions or Debridement

Perineum Obstetric

Pelvis (Except Hip) Other Procedures

Upper Leg (Except Knee)

Conclusion

Questions / Concerns