Transmyocardial Revascularization is recommended by the American College of Cardiology / American Heart Association22, the Society of Thoracic Surgeons27, and the International Society of Minimally Invasive Cardiothoracic Surgeons40, and reimbursed as a primary treatment and as a secondary treatment to coronary artery bypass grafting.
MS-DRG Terminology and Coding (Effective October 1, 2011)
CMS continues with the implementation of its new payment system based on Medical Severity Diagnosis Related Groups (MS-DRG) which became effective October 1, 2007.
Based on a TMR patient’s medical severity and associated resource utilization, TMR patients typically are discharged under one of the following MS-DRGs 228/229/230 (see chart above).
International Classification of Diseases, 9th Rev, Clinical Modification (ICD-9-CM) Procedure Codes
36.31 – Open Chest TMR
36.32 – Other TMR
36.33 – Endoscopic TMR
Physician Current Procedural Terminology (CPT)
33140 – Transmyocardial laser revascularization (stand alone procedure)
33141 – Transmyocardial laser revascularization performed at the time of other open cardiac procedure(s) (list separately in addition to code for primary procedure)
The coding information provided is gathered from third-party sources and has not been verified with any entity responsible for coding policy, such as the AMA or the ICD-9 Committee, or any payer. As such, the information set forth in this document is for illustrative purposes only and does not constitute a recommendation by Cardiogenesis as to how to code for TMR. Cardiogenesis makes no representation or warranty that any payer will agree with the choice of codes described herein. Reasonable efforts have been made to ensure the accuracy of this information, but the ultimate responsibility for coding and claims submission lies with the physician, clinician, hospital or other facility. Cardiogenesis also makes no representation or warranty regarding coverage or payment of procedures by any payer involving TMR. Reimbursement policies change frequently and can vary considerably from one insurer to another. Cardiogenesis strongly recommends that you consult your payers for interpretation of pertinent coding, coverage and reimbursement policies.