For 2023, CPT® approved new codes for pulmonary angiography, including code 93575, for selective pulmonary angiography of major aortopulmonary collateral arteries (MAPCAs) arising off the aorta or its systemic branches, during cardiac catheterization for congenital heart defects, each distinct vessel.
However, the National Correct Coding Initiative (NCCI) Medically Unlikely Edit (MUE) only allows one unit per day, which is inconsistent with clinical practice.
SCAI's appeal asks that the number of units per day increase to better align with the number of vessels commonly identified.
In the meantime, 93575's MUE indicator of 3 allows appeals for additional units with supporting documentation.
UPDATE: CMS reviewed the appeal and has agreed to make changes to the MUE for 93575 to increase the Medicaid MUE value for 93575 to 10 and the Medicare MUE value to 4. CMS anticipates the changes to be implemented in the July 2023 edit files.
What's Happening at SCAI
Updates on the Society's publications, advocacy initiatives, fundraising, professional recognition programs, research, and collaborations with partners.