medtronic structural heart icd-10 coding for hospitals · icd-10 went into effect october 1, 2015....

Medtronic Structural Heart ICD-10 Coding for Hospitals

Linda Holtzman RHIA, CCS, CCS-P, CPC,COCClarity CodingJanuary 2016

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DisclaimerReimbursement information provided by Medtronic is for illustrative purposes only and does not constitute legal advice.

Information provided is gathered from third party sources and is subject to change without notice due to frequently changing laws, rules and regulations. Medtronic makes no guarantee that the use of this information will prevent differences of opinion or disputes with Medicare or other third party payers as to the correct form of billing or the amount that will be paid to providers of service.

The provider of service has the responsibility to determine medical necessity and to submit appropriate codes and charges for care provided. Please contact your local payers, reimbursement specialists and/or legal counsel for interpretation of coding, coverage, and payment policies.

Medtronic does not promote the use of its products outside FDA-approved labeling.

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ICD-10-PCS Procedure Codes

ICD-10-CM Diagnosis Codes

Background and Framework

Topics

Appendix : Key Resources

DRG Impact

Attachment : Diagnosis Code Crosswalks

Questions

Background and Framework

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Effective Date

ICD-10 went into effect October 1, 2015.

ICD-10-CM for diagnosis codes and ICD-10-PCS for procedure codes go into effect together on the same date.

ICD-10 is effective by date of discharge, not by date of admission.

Use of ICD-10 in the United States was formally proposed in August 2008 and finalized in January 2009.

Implementation of ICD-10 was initially scheduled for October 2013 and has been postponed twice since then.

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Who Uses What

Provider Setting Diagnoses Procedures

Hospitals Inpatient ICD-10-CM ICD-10-PCS

Hospitals Outpatient ICD-10-CM CPT

Physicians Facility/Office ICD-10-CM CPT

ASCs Outpatient ICD-10-CM CPT

Hospitals, physicians and all other providers must use ICD-10 diagnosis codes.

Hospitals must also use ICD-10-PCS procedure codes for inpatient cases.

Implementation of ICD-10 does not affect use of CPT.

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ICD-10 Coding Guidelines

Guidelines for use of ICD-10 are available from multiple credible sources.

The ICD-10 Official Guidelines for Coding and Reporting

Instructions within the ICD-10 codebook itself

Coding Clinic and AHA Coding Clinic Advisor

Minutes from meetings of the ICD-10 Coordination and Maintenance Committee

AHA ICD-10-CM and ICD-10-PCS Coding Handbook

AHIMA ICD-10-PCS: An Applied Approach

ICD-10-PCS Reference Manual

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General Equivalence MappingsGeneral Equivalence Mappings (GEMs) are useful tools for going back-and-forth between ICD-9 and ICD-10 codes, for both diagnoses and procedures.

Forward GEMs go from ICD-9 to ICD-10; Backward GEMs go from ICD-10 to ICD-9.

The GEMs can be found at: http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2105

GEMs can be a good starting place. But NCHS and CMS strongly recommend coding directly from the ICD-10 codebooks, as studies have consistently indicated that this is most accurate.

http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

ICD-10-CM Diagnosis Codes

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Codes are organized by chapter, mostly by body system. The chapters are virtually identical to those in ICD-9-CM.

Codes are alpha-numeric and can be 3 to 7 digits long.

Talpha

8number

2alpha or number

2 3 A

Category Details Extension

2T82.223ALeakage of biological heart valve graft, initial encounter

Q 2 1

3Q21.3Tetralogy of Fallot

I 2 5

1I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris

0

Decimal

Diagnosis Code Structure

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Volume of Diagnosis Codes

ICD-9-CM14,567 codesICD-10-CM

69,823 codes

ICD-10-CM has far more diagnosis codes than ICD-9-CM and provides a greater level of specificity.

Example: Non-rheumatic aortic valve disordersICD-9-CM ICD-10-CM

424.1 Aortic valve disorders

I35.0 Non-rheumatic aortic (valve) stenosisI35.1 Non-rheumatic aortic (valve) insufficiency (regurgitation)I35.2 Non-rheumatic aortic (valve) stenosis with insufficiencyI35.8 Other non-rheumatic aortic valve disordersI35.9 Non-rheumatic aortic valve disorder, unspecified

Example: Mechanical complication of coronary artery bypass graftICD-9-CM ICD-10-CM

996.03

Mechanical complicationdue to coronary artery bypass graft

T82.211A Breakdown (mechanical) of coronary artery bypass graft, initial encounter

T82.212A Displacement of coronary artery bypass graft, initial encounter

T82.213A Leakage of coronary artery bypass graft, initial encounter

T82.218A Other mechanical complication of coronary artery bypass graft, initial encounter

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Valve Disorders

Valve disease with involvement of multiple valves (aortic, mitral, tricuspid) is coded as rheumatic whether documented as rheumatic or not.

Aortic valve stenosis and pulmonary valve disorders default to non-rheumatic.

Mitral valve stenosis and tricuspid valve disorders default to rheumatic.

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Angina and Coronary Artery Disease Angina codes (I20) are not assigned separately if the patient

also has CAD. A combination code is used instead.

A cause-and-effect relationship between angina and CAD can be assumed.1

1. ICD-10-CM Official Guidelines for Coding and Reporting (Diagnoses), FY 2015, p.42

Does the patient also have angina? What kind of vessel has coronary atherosclerosis? What kind of angina?

To code CAD in ICD-10-CM, the coder must know three things:

Code Description Notes

I25.10 Atherosclerotic heart disease of native coronary artery without angina pectoris Use for CAD or ASHD NOS without angina

I25.119 Atherosclerotic heart disease of native coronary artery with unspecified angina pectoris Use for CAD or ASHD NOS with angina

I25.709 Atherosclerosis of coronary artery bypass graft(s), unspecified, with unspecified angina pectoris Use for CAD or ASHD with CABG with angina

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Device Complications Mechanical complication is defined the same way in ICD-10-CM

as it is in ICD-9-CM.

ICD-10-CM differentiates between mechanical complications of artificial valves and tissue valves.

Code Description Notes

T82.01xA Breakdown (mechanical) of heart valve prosthesis, initial encounter Artificial valve devices (metallic)

T82.221A Breakdown (mechanical) of biological heart valve graft, initial encounter

Tissue valve devices, including bio-prosthetics

Occlusion of a coronary artery bypass graft due to atherosclerosis is not coded as a complication. Use I25.7 instead.2

2. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.535

ICD-10-CM has a specific code for infection of heart valve device.Code Description Notes

T82.6xxA Infection and inflammatory reaction due to cardiac valve prosthesis, initial encounter Heart valve devices (any type)

T82.7xxA Infection and inflammatory reaction due to other cardiac and vascular devices, implants, and grafts, initial encounter All other cardiac devices

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Device Complications

ICD-9-CM ICD-10-CM

996.71

996.72

Other complicationdue to heart valve prosthesis

Other complication due to othercardiac device,implant and graft (including coronary artery bypass graft)

T82.817A Embolism of cardiac prosthetic devices, implants and grafts, initial encounterT82.827A Fibrosis of cardiac prosthetic devices, implants and grafts, initial encounterT82.837A Hemorrhage of cardiac prosthetic devices, implants, grafts, initial encounterT82.847A Pain from cardiac prosthetic devices, implants and grafts, initial encounterT82.857A Stenosis of cardiac prosthetic devices, implants and grafts, initial encounterT82.867A Thrombosis of cardiac prosthetic devices, implants, grafts, initial encounter

T82.897A Other specified complication of cardiac prosthetic devices, implants and grafts, initial encounter

For other (non-mechanical) complications, ICD-10-CM differentiates the type of complication but not the type of device.

Proposals have already been made to ICD-10 C&M Committee to create new codes that provide more detail on the specific device.

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Status and EncounterICD-9-CM ICD-10-CM

V42.2 Heart valve replaced by transplant (tissue) Z95.3 Presence of xenogenic heart valve

Z95.4 Presence of other heart valve replacement

V43.3 Heart valve replaced by other means (artificial) Z95.2 Presence of prosthetic heart valve

V45.81 Aortocoronary bypass status Z95.1 Presence of aortocoronary bypass graft

V53.39 Fitting and adjustment of other cardiac device Z45.09 Encounter for adjustment and management of other cardiac device

Code Z95.2 is used for the presence of a mechanical heart valve. It is also the default code for the presence of any non-native valve.

Expected end-of-life for a heart valve graft is not coded as a complication. Use Z45.09 instead.3

Code Z95.3 is used for the presence of animal tissue valves, including bioprosthetics, eg. CoreValve.

Code Z95.4 is used for the presence of a homograft valve.

3. Coding Clinic, 2nd Q 2008

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TAVR: Valve-in-ValveIn mid-2015, transcatheter aortic valve replacement received a new indication for treatment of “failure” of a previously placed bioprosthetic valve. For coding purposes, the key factor is whether the

“failure” is a complication or an expected occurrence.

Scenario ICD-10-CM

Malposition or displacement of previously placed valve T82.222A Displacement of biological heart valve graft, initial encounter

Premature stenosis of the previously placed valve T82.857A Stenosis of cardiac prosthetic devices, implants and grafts,

initial encounter

Premature regurgitation of the previously placed valve T82.223A Leakage of biological heart valve graft, initial encounter

Expected degeneration of previously placed valve (end-of-life) Z45.09 Encounter for adjustment and management of other cardiac

device

Seventh digit “A” is correct for the complication codes because active treatment is provided for the valve failure.4

4. Coding Clinic, 1st Q 2015

ICD-10-PCSProcedure Codes

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ICD-10-PCS Format

Codes are alpha-numeric and are always 7 digits long.

Each position in an ICD-10-PCS procedure code represents a distinct element.

1 2 3 4 5 6 7

sectionbody system

root operation approach qualifierbody part device

There is no decimal point.

There are virtually no unspecified or default codes.

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Structure of ICD-10-PCS Codes In ICD-10-PCS, codes are not assigned per se. They are

constructed, character by character.

ICD-10-PCS contains no instructional notes.

Standardized terms and definitions are used throughout.

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Volume of Procedure Codes ICD-10-PCS has far more procedure codes than ICD-9-CM and provides much greater specificity.

CABG: ICD-9-CM 9 codes ICD-10-PCS 232 codes

ICD-9-CM3,882 codesICD-10-PCS71,962 codes

Use of ICD-10-PCS requires in-depth clinical and technical coding knowledge: Relevant clinical anatomy Procedural components Exact nature of devices used Standard terms, particularly Root Operation Procedure coding guidelines and precedents

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Structural Heart Procedures

Surgical Valve Replacement Valve Annuloplasty Transcatheter Aortic Valve Replacement

Transcatheter Pulmonary Valve Replacement

Aortic Root Replacement Valved Conduit Implantation

CABG Cardiopulmonary Bypass

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Surgical Valve Replacement

Surgical valve replacement refers to open removal of the native valve and implantation of a new valve, either tissue or mechanical.

Root Operation

Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part

Coding Guidelines

Removal of the native valve is not coded separately.5

5. ICD-10-PCS Official Guidelines for Coding and Reporting (Procedures), FY 2015, B3.1b

R - Replacement

pulmonary valve

tricuspid valve

aortic valve

mitral valve

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Devices 8 – Zooplastic Tissue : 3f, Hancock, Mosaic J – Synthetic Substitute : Open Pivot

Example

02RF08Z Replacement of aortic valve with zooplastic tissue, open approach Open chest excision of aortic valve, implantation of Mosaic valve

Surgical Valve Replacement

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Valve Annuloplasty

Annuloplasty involves repairing a leaky valve by placing a ring around the valve opening to support the leaflets and bring them together properly.

Root Operation

Putting in or on biological or synthetic material that physically reinforces and/or augments the function of a portion of a body part

U - Supplement6

6. ICD-10-PCS Reference Manual, FY 2015, p.71

Devices

J – Synthetic Substitute : Contour 3D, Profile 3D

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Example

02UJ0JZ Supplement, tricuspid valve with synthetic substitute, open approach

Annuloplasty using Contour 3D tricuspid annuloplasty ring

Valve Annuloplasty

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Transcatheter Aortic Valve Replacement

This procedure is usually abbreviated TAVR or TAVI.

Procedural Components Access is usually through the femoral artery, though it may also be

through other access such as the subclavian artery or transaorticapproach for the Medtronic CoreValve device

The catheter is advanced through the aorta and over the native valve. Valvuloplasty may be performed to crush the native valve. The delivery catheter is placed over the remains of the native valve

and expanded to deploy the new valve.

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Root Operation

Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part

Coding Guidelines Based on the Explanation, balloon valvuloplasty to

eradicate the native valve is not coded separately when performed.

R - Replacement


Explanation: The body part may have been taken out or replaced, or may be taken out, physically eradicated, or rendered nonfunctional during the Replacement procedure.7


Devices 8 – Zooplastic Tissue : CoreValve

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Example

02RF38Z Replacement of aortic valve with zooplastic tissue, percutaneous approach

TAVR with implantation of CoreValve


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TAVR: Valve-in-Valve Procedure


In a valve-in-valve procedure, a new transcatheter valve is placed directly within the failed previous valve device. Root Operation

Valve-in-valve is a redo of the prior valve replacement procedure. The previous valve is rendered non-functional and is replaced with an entirely new valve.

R - Replacement

A complete re-do of a procedure is coded to the root operation performed. By definition, root operation R-Replacement continues to be used when a device that replaces a body part is itself replaced. 8

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The aortic root is the distal end of the ascending thoracic aorta.

Aortic Root Replacement

valveleaflets

ostium of coronary arteryvalve

annulus

The place where the aortic root joins the left ventricle of the heart is the aortic valve. In other words, the aortic valve sits inside the aortic root.

The coronary arteries arise from the aortic root, just before the aorta joins the left ventricle of the heart.

ascending thoracic

aorta

aortic root

Anatomyaortic arch

coronary artery

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The aortic root may be replaced due to, for example, a congenital anomaly or an aortic root aneurysm.

There are three different procedural scenarios.

Procedure Scenario 1

Freestyle is used to replace the aortic valve with no other distinct procedural components.

Code as a surgical valve replacement.

Devices 8 – Zooplastic Tissue : Freestyle Aortic Root

Procedural Components

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9. See Coding Clinic 4th Q 2013


Freestyle is used to replace the aortic valve as well as a portion of the aortic root.

Code as a surgical valve replacement.

The coronary artery “buttons” must be popped off and later re-implanted.

A coding proposal addressing re-implantation of coronary buttons was presented at the March 2015 C&M meeting, so further guidance and possible code table changes may be forthcoming.

At this time, precedent indicates that re-implanting the coronary buttons should not be coded separately.9

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10. See Coding Clinic 4th Q 2013


Code a surgical valve replacement.

The adjacent segment of the ascending thoracic aorta is excised and replaced by a separate graft, which is anastomosed to the Freestyle.

Freestyle is used to replace the aortic valve as well as a significant portion of the aortic root.

The coronary artery buttons are popped off and later re-implanted.

At this time, do not code re-implanting the coronary artery buttons.

Assign a separate code for the ascending aorta graft.10

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Example

02RF08Z Replacement of aortic valve with zooplastic tissue, open approach

Aortic valve and aortic root replacement with Freestyle bioprosthesis, excision of ascending aorta and replacement with synthetic graft


02RW0JZ Replacement of thoracic aorta with synthetic substitute, open approach11

11. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.435

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Valved Conduit ImplantationA valved conduit is exactly that: a tube with a valve inside. Device

8 – Zooplastic Tissue: Contegra

Humanitarian Use Device:Authorized by Federal law for use in patients under 18 years of age for correction or reconstruction of the Right Ventricular Outflow Tract (RVOT) in the following congenital heart malformations: Pulmonary Stenosis, Tetralogy of Fallot, Truncus Arteriosus, Transposition with Ventricular Septal Defect (VSD), Pulmonary Atresia. In addition, the Contegra Pulmonary Valved Conduit is indicated for the replacement of previously implanted but dysfunctional pulmonary homografts or valved conduits. The effectiveness of this device for these uses has not been demonstrated.

The Contegra Pulmonary Valved Conduit is an RV-PA conduit.

There are two different procedural scenarios:Procedural Components

completely replace a previously placed RV-PA conduit

reconstruct the right ventricular outflow tract in congenital heart malformations

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Valved Conduit ImplantationRoot Operation 1 – Bypass, and this is used in both procedural scenarios12

Coding Guidelines For Bypass, the fourth character shows the body part being bypassed

from and the qualifier shows the body part being bypassed to.13

13. ICD-10-PCS Official Guidelines for Coding and Reporting (Procedures), FY 2015, B3.6a 12. Coding Clinic, 3rd Q 2014

Example

021K0KP Bypass right ventricle to pulmonary trunk with nonautologous tissue substitute, open approach14

Removal of prior RV-PA conduit and replacement with a new Contegrapulmonary valved conduit

14. Coding Clinic, 4th Q 2014

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Transcatheter Pulmonary Valve Rplcmnt

This procedure is usually abbreviated TPVI.

Patients who undergo transcatheter pulmonary valve replacement with the Medtronic device have previously had a valved RV-PA conduit placed.

The previously placed RV-PA conduit has either developed complications or reached its expected end-of-life and now needs to be replaced.

valve location within conduit

RV-PA conduit The conduit itself is not replaced

but a new valve is placed inside it.

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Transcatheter Pulmonary Valve RplcmntProcedural Components

The catheter is advanced through the vena cava into the right atrium, through the tricuspid valve, and into the right ventricle.

Valvuloplasty is performed to crush the previously placed valve and prepare the site.

The delivery catheter is placed over the remains of the previously placed valve and expanded to deploy the new valve inside the conduit.

From the right ventricle, the catheter is advanced into the previously placed valved conduit.

Access is usually through the femoral vein.

Root Operation R - Replacement

Devices 8 – Zooplastic Tissue : Melody

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Coding Guidelines Balloon valvuloplasty is not coded separately.

Transcatheter Pulmonary Valve Rplcmnt

There are no published coding guidelines specifically addressing replacement of a pulmonary valve within an RV-PA conduit.15

15. See also AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.420

Example

02RH38Z Replacement of pulmonary valve with zooplastic tissue, percutaneous

Transcatheter pulmonary valve replacement with Melody

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CABGCoding Guidelines For Bypass for CABG, the fourth character shows the number of

coronary artery sites being bypassed and the qualifier shows the vessel bypassed from, ie. the vessel now supplying the blood.16

The Device character refers to use of a free graft between the vessels:17

16. ICD-10-PCS Official Guidelines for Coding and Reporting (Procedures), FY 2015, B3.6b

9 – autologous venous graft, eg. saphenous vein graft A – autologous arterial graft, eg. radial artery graft J – synthetic substitute, eg. Gore-Tex graft K – nonautologous tissue substitute, eg. cadaveric vessel

Z – no device Use of hypothermia, cardioplegia, intraoperative pacing, and chest

tube insertion are all integral and not coded separately.17

Use of cardiopulmonary bypass is coded separately.17

Harvest of an autologous free graft is also coded separately.17

17. AHA ICD-10-CM and ICD-10-PCS Coding Handbook, FY 2015, p.423-427

If the vessels are connected directly without use of a free graft:17

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Example

021109W Bypass coronary artery, two sites from aorta with autologous venous tissue, open approach

CABG, aortocoronary bypass to OM branch of LCx and RCA via (right) saphenous vein graft (endoscopic harvest), and LIMA to LAD

CABG

02100Z9 Bypass coronary artery, one site from left internal mammary, open06BP4ZZ Excision of right greater saphenous vein, perc endoscopic approach

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Example

5A1221Z Performance of cardiac output, continuous

Cardiopulmonary bypass

Cardiopulmonary Bypass

Coding Guidelines Use of CPB is coded separately with the primary procedure, eg. valve

replacement, CABG. Insertion of the cannulae is not coded separately.

DRG Impact

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ICD-10 DRG ConversionThe conversion of the DRG Grouper is about coding, not about grouping.

The same DRG will be assigned regardless of whether the case is coded in ICD-9 or ICD-10.

CMS has repeatedly stated its goal in the DRG conversion:

The conversion process has involved only replacing the ICD-9-CM codes with the equivalent ICD-10 codes.

DRG titles and underlying DRG logic has not changed, but some minor DRG variations are unavoidable. In a study of 10 million FY 2013 MedPAR records, CMS found a

DRG shift of 1.07%, with reimbursement change of -0.04%18

18. Estimating the Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Paymentshttp://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/Downloads/2015-03-18-Impact-ICD10-Transition.pdf

If the same DRG is not assigned, recheck the codes

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Sample CCs

Code DescriptionE44.0-E46 other malnutrition

E87.0 hypernatremiaE87.1 hyponatremia I31.4 cardiac tamponade

I42.0, I42.5, I42.8-I42.9

cardiomyopathy (non-ischemic) (dilated, congestive, constrictive, restrictive)

I44.2 AV block, complete I45.2 bifascicular block I45.3 trifascicular block

I45.89 other conduction disorder I47.2 ventricular tachycardiaI50.1 left ventricular failure

I50.20 systolic heart failure, unspecifiedI50.22 systolic heart failure, chronic I50.30 diastolic heart failure, unspecifiedI50.32 diastolic heart failure, chronic

I50.40 combined diastolic/systolic heart failure, unspecified

I50.42 combined diastolic/systolic heart failure, chronic

Code Description

I82.409-I82.891 venous thrombosis and embolism

J44.1 acute exacerbation of COPD

J80 acute respiratory distress syndrome (adult, child)

J90, J94.2, J94.8 pleural effusion, hemothorax, hydrothorax (non-traumatic)

J95.811-J95.812 iatrogenic pneumothorax, air leakJ96.10-J96.12 respiratory failure, chronicJ98.11-J98.19 atelectasis, pulmonary collapse

K56.0,K56.60-K56.7 bowel obstruction, ileus

N17.8-N17.9 acute renal failure, other and unspecified

N18.4 CKD, stage IV N18.5 CKD, stage V N39.0 urinary tract infection

R65.10 SIRSR78.81 bacteremia Z68.1 BMI less than 19, adult

Z68.41-Z68.45 BMI 40 and over, adult

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Sample MCCs

Code DescriptionA40.0-A40.9, A41.01-A41.9 septicemia, sepsis

E41-E43 severe malnutritionI21.01-I21.4, I22.0-I22.9 acute myocardial infarction

I26.01-I26.99 pulmonary embolismI50.21 systolic heart failure, acuteI50.23 systolic heart failure, acute on chronicI50.31 diastolic heart failure, acuteI50.33 diastolic heart failure, acute on chronicI50.41 combined diastolic/systolic heart failure, acuteI50.43 combined diastolic/systolic heart failure, acute on chronic

J12.0-J18.9 pneumoniaJ69.0 aspiration pneumoniaJ81.0 acute pulmonary edema

J96.00-J96.02 respiratory failure, acuteJ96.20-J96.22 respiratory failure, acute on chronic N17.0-N17.2 acute renal failure, specified lesion

N18.6 ESRDR65.20-R65.21 severe sepsis

Appendix: Key Resources

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Key Websites NCHS and CMS have a wealth of ICD-10 resources and educational materials available on-line.NCHS http://www.cdc.gov/nchs/icd/icd10cm.htm#icd2105

• ICD-10-CM Tabular and Index • Diagnosis code GEMS• Official ICD-10-CM guidelines (diagnoses)

• ICD-10-PCS Code Tables and Index• Official ICD-10-CM guidelines (procedures)

CMS http://www.cms.gov/Medicare/Coding/ICD10/2015-ICD-10-CM-and-GEMs.html

• Procedure code GEMs

Procedures: http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/ ICD-9-CM-C-and-M-Meeting-Materials.html

ICD-10 Coordination and Maintenance Committee

• Code proposals, presentation slides, videos, summaries

Diagnoses: http://www.cdc.gov/nchs/icd/icd9cm_maintenance.htm

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Medtronic Contacts Medtronic is available to assist with your ICD-10 questions and issues. Medtronic Cardiovascular Hotline: 1-866-616-8400

Email us:[email protected]

Reach out to the Reimbursement Team directly:Angelica Oyugi, RHIA, Principal [email protected]

Bonnie Handke, Sr. Director [email protected]

We’re here to help make this

transition smoother for you

Ann Scott, Program Director [email protected]

© 2016Medtronic. All rights reserved. UC201506613a EN

Kimberly Munro: Cell: 440-340-8266 Email: [email protected] Plis: Cell: 518-573-5277 Email: [email protected] Stamper-Strelitz: Cell: 404-242-6188 Email: [email protected]

Pacific Northwest: Teresa Stamper-Strelitz

SouthEast: Teresa Stamper-Strelitz

Capital: Teresa Stamper-Strelitz

Hollywood: Kim Munro

Midwest: Teresa Stamper-Strelitz

N North Central : Kim Munro

Greater NY: Jean Plis

N Northeast: Jean Plis

P PA Great Lakes: Kim Munro

South Central: Jean Plis

Structural Heart Health Care Economics, Policy and PaymentUC201605543 EN © 2016 Medtronic . All Rights Reserved. 01/2016

Health Economics & Reimbursement Regional Team

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medtronic structural heart icd-10 coding for hospitals · icd-10 went into effect october 1, 2015....

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