1. UNIT 5 DISEASES CARDIOVASCULAR SYSTEM & ANESTHESIA CODING HI250 Medical Coding II

2. 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

3. Learning Objectives Diseases of the Cardiovascular System Cardiovascular CPT Coding Anesthesia Coding

4. 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?

5. 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?

6. ICD-9-CM Cardiovascular Coding Guidelines Hypertension CVA Postoperative cerebrovascular accident Late effects of cerebrovascular disease AMI

7. CPT Cardiovascular Guidelines Selective Vascular Catheterization Heart 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

8. 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

9. 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

10. 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

11. CPT Anesthesia Overview Types of Anesthesia  General anesthesia  Local anesthesia  Regional anesthesia

12. Anesthesia Guidelines Reporting Codes for Monitoring or Providing Other Services Emergency Endotracheal Tube Intubation Central Venous Access Devices Intra-Arterial Lines Drug Administration Codes

13. Anesthesia Guidelines (Continued) Anesthesia Modifiers HCPCS Level II Anesthesia Modifiers Physical Status Modifiers CPT Modifiers Time Reporting Physician’s Services Materials Supplied by Physician Separate or Multiple Procedures Separate Report Qualifying Circumstances

14. Anesthesia Subsections HeadKnee and Popliteal Area NeckLower Leg ThoraxShoulder and Axilla IntrathoracicUpper Arm and Elbow Spine and Spinal CordForearm, Wrist and Hand Upper AbdomenRadiological Procedures Lower AbdomenBurn Excisions or Debridement PerineumObstetric Pelvis (Except Hip)Other Procedures Upper Leg (Except Knee)

15. Conclusion Questions / Concerns