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ICD-10-CM T82.222A, Displacement of biological heart valve graft, initial encounter | No Prior Auth

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`T82.222A`, Displacement of biological heart valve graft, initial encounter

ICD-10-CM

Prior Authorization

No Prior Auth Required

Covered without prior authorization (high confidence)

Documentation Required

All documentation must be maintained in the patient's medical record and made available to the contractor upon request.
Every page of the record must be legible and include appropriate patient identification information, including complete name and dates of service.
The documentation must include the legible signature of the physician or non-physician practitioner responsible for and providing the patient's care.

The submitted medical record must support the use of the selected ICD-10-CM code(s).

The submitted CPT/HCPCS code must accurately describe the service performed.

When a limited or follow-up echocardiogram is performed, document the targeted cardiac problem/region and bill using the appropriate CPT code (93308 or 93321).

Key Coverage Criteria

When billing Medicare Part B for analysis of a Wearable Defibrillator System, report CPT code 93292.
Report CPT codes 93260, 93261, and 93279-93292 when performing the corresponding cardiac rhythm device evaluation procedures (reported per procedure).
Follow-up or limited transthoracic echocardiography performed to evaluate a single specified cardiac problem or region must be billed with CPT 93308.
Limited Doppler/follow-up echocardiographic studies (for targeted velocity or gradient assessment) should be billed with CPT 93321 (e.g., tricuspid regurgitant velocity to estimate pulmonary artery systolic pressure or sequential transmitral velocity in mitral stenosis).
Coverage and clinical indications for Cardiac Computed Tomography & Angiography (CCTA) follow the Local Coverage Determination LCD L33423; this billing article provides complementary coding guidance only.
Transthoracic echocardiography (TTE) is covered when the patient's medical record documents medical necessity consistent with the LCD indications for TTE.

13 Active Policies

CGS-J15-L34338, Transthoracic Echocardiography (TTE)

J15

CGS-J18-L34338, Transthoracic Echocardiography (TTE)

J18

A56781, Billing and Coding: Transthoracic Echocardiography (TTE)

J6

NGS-J6-L33577, Transthoracic Echocardiography (TTE)

J6

NOVITAS-JH-L34833, Cardiac Rhythm Device Evaluation

JH

NGS-JK-L33577, Transthoracic Echocardiography (TTE)

JK

A56602, Billing and Coding: Cardiac Rhythm Device Evaluation

JL

NOVITAS-JL-L34833, Cardiac Rhythm Device Evaluation

JL

A56691, Billing and Coding: Cardiac Computed Tomography & Angiography (CCTA)

A56625, Billing and Coding: Echocardiography

A57306, Billing and Coding: Transthoracic Echocardiography (TTE)

A57326, Billing and Coding: Electrocardiograms

A59657, Billing and Coding: Artificial Hearts and Percutaneous Endovascular Cardiac Assist Procedures and Devices

Related Codes

I25.810(13 policies)I25.89(13 policies)I25.5(13 policies)I25.6(13 policies)I25.811(13 policies)I25.812(13 policies)I25.10(13 policies)I42.0(13 policies)

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