Documenting and Coding Bradycardia – Use These Medical Codes

1. Documenting and Coding Bradycardia – Use These Medical Codes Bradycardia is a slow or irregular heart rhythm, fewer than 60 beats per minute. Read the article to know about the symptoms, treatment options and related medical codes. Outsource Strategies International United States

2. Bradycardia refers to a cardiac condition wherein your heart rate is abnormally slower than the normal heart rate. A normal heartbeat is expected between 60 and 100 beats per minute (BPM). A person's heart rate generally slows with age and while resting. In most cases, changes in heart rate depend on a person's activity level. Adults with a resting heart rate of less than 60 beats per minute (BPM) qualify for bradycardia. During intense physical exertion, the heart has to pump faster and harder, so the rate goes up. However, there are exceptions. Athletes and people who are asleep may also have slow heart rates below 60 BPM. The condition can be a serious problem if the heart doesn’t pump enough oxygen-rich blood to the body. Implanting a pacemaker can correct bradycardia and help your heart maintain an appropriate rate. Cardiologists and other primary care physicians providing treatment for this condition need to have correct knowledge about the related codes to submit claims and get paid. Partnering with an experienced cardiology medical billing company is the best option for health practitioners for timely claim filing and receiving appropriate reimbursement. Generally, people experience moderate to occasional bradycardia. While it is extremely important for persons with slow heart rate to seek medical guidance, not everyone will require treatment. When bradycardia causes no other symptoms, and when a person does not have an underlying condition, a slow heart rate can be considered a minor issue. Other potential medical conditions that can cause a slow heart rate include – heart tissue damage due to aging, congenital heart defect, obstructive sleep apnea, heart attack, myocarditis, complications of heart surgery, hypothyroidism, and usage of certain medications (including some drugs for other heart rhythm disorders, high blood pressure and psychosis). www.outsourcestrategies.com 918-221-7769

3. Symptoms and Risk Factors Slow heart rate is one of the primary symptoms associated with the condition. Other related symptoms include – Shortness of breath Near-fainting or fainting (syncope) Feelings of exhaustion and weakness Fatigue Easily tiring during physical activity Dizziness or lightheadedness Confusion or memory problems Confusion Chest pains When a serious medical condition causes bradycardia and a person does not seek treatment, more severe symptoms such as chest pain, cardiac arrest, cardiac arrest, low or high blood pressure and heart failure may appear. Heart problems, which are often associated with bradycardia, are quite common in older adults. A key risk factor for this condition is age. Other related factors that increase the risk of this condition include – high blood pressure, smoking, recreational drug use, heavy alcohol use and psychological stress or anxiety. Diagnosing and Treating Slow Heart Rate To diagnose this cardiac condition, physicians will conduct a review of your symptoms, evaluate previous medical and family history and conduct a detailed physical examination. They will conduct tests to measure heart rate by taking their pulse. In addition, physicians will conduct other related tests such as Electrocardiogram (ECG or EKG), Tilt table test and exercise tests to measure your heart rate, establish a link between a slow heart rate and your www.outsourcestrategies.com 918-221-7769

4. symptoms, and identify conditions that might be causing bradycardia. Blood tests may be conducted to screen for infections, hypothyroidism or an electrolyte imbalance. On the other hand, sleep tests may also be performed - if sleep apnea is expected to be a contributing factor for bradycardia symptoms. People with slow heart rate do not always require treatment. On the other hand, treatment becomes important when a slow heart rate causes serious health problems. Treatment modality may depend on the type and severity of symptoms, related causes and the type of electrical conduction problem. If an underlying disorder such as hypothyroidism or obstructive sleep apnea is causing bradycardia, medications will be prescribed to correct problems with a slow heart rate. However, if the heart rate does not improve with medications, an artificial pacemaker (an electrical device) will be inserted in to the heart to support regular heart rhythms. The pacemaker monitors your heart rate and generates electrical impulses as necessary to maintain an appropriate rate. The diagnosis tests and treatment procedures performed by physicians must be documented by using the correct medical codes. Medical billing and coding services provided by reputable billing companies can help physicians use the correct codes for their medical billing purposes. ICD-10 Codes for Bradycardia R00 - Abnormalities of heart beat R00.0 - Tachycardia, unspecified R00.1 - Bradycardia, unspecified R00.2 - Palpitations R00.8 - Other abnormalities of heart beat R00.9 - Unspecified abnormalities of heart beat www.outsourcestrategies.com 918-221-7769

5. CPT Codes Insertion of Single Chamber and Dual Chamber Permanent Cardiac Pacemakers 33206 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial 33207 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular 33208 - Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular Pacemaker Device Monitoring 93279 Programming evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; single lead pacemaker system 93280 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead pacemaker system 93281 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead pacemaker system 93282 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, www.outsourcestrategies.com 918-221-7769

6. review and report by a physician or other qualified health care professional; single lead transvenous implantable defibrillator system 93283 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; dual lead transvenous implantable defibrillator system 93284 Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional; multiple lead transvenous implantable defibrillator system 93287 Peri-procedural device evaluation (in person) and programming of device system parameters before or after a surgery, procedure, or test with analysis, review and report by a physician or other qualified health care professional; single, dual, or multiple lead implantable defibrillator system 93288 Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple pacemaker system 93289 Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; single, dual, or multiple lead transvenous implantable defibrillator system, including analysis of heart rhythm derived data elements www.outsourcestrategies.com 918-221-7769

7. 93290 - Interrogation device evaluation (in person) with analysis, review and report by a physician or other qualified health care professional, includes connection, recording and disconnection per patient encounter; implantable cardiovascular physiologic monitor system, including analysis of 1 or more recorded physiologic cardiovascular data elements from all internal and external sensors 93294 Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional 93295 Interrogation device evaluation(s) (remote), up to 90 days single, dual, or multiple lead implantable defibrillator system with interim analysis, review(s) and report(s) by a physician or other qualified health care professional 93296 Interrogation device evaluation(s) (remote), up to 90 days single, dual, or multiple lead pacemaker system or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results 93298 Interrogation device evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm monitor system, including analysis of recorded heart rhythm data, analysis, review(s) and report(s) by a physician or other qualified health care professional 93299 Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results www.outsourcestrategies.com 918-221-7769

8. Heart problems are considered one of the leading causes of death in the United States – accounting for one out of every four deaths. Therefore, it is important for people to consider any changes in heart health, blood pressure or pulse rate seriously. Preventing the occurrence of bradycardia requires people to reduce the potential risk factors related to developing heart disease. Incorporating healthy lifestyle habits such as – consuming a healthy diet, maintaining adequate body weight, keeping blood pressure and cholesterol under control, quitting the habit of smoking and alcohol consumption, stopping the usage of recreational drugs and managing stress can help eliminate the potential risk factors that may lead to the development of heart disease. On the other hand, for people who already have heart disease - conducting regular health checkups, monitoring symptoms, and making regular follow ups can help reduce their risk of bradycardia. As there are several rules for reporting cardiac conditions, billing and coding for bradycardia can be challenging. Selection of the right ICD-10 codes is important for correctly describing the patient’s condition. By partnering with an experienced medical billing company that offers the services of AAPC- certified coding specialists, healthcare practices can ensure complete and accurate documentation, code assignment and claims submission. www.outsourcestrategies.com 918-221-7769