ZHealth News

October 2016 Q & A

Question: Femoral Stent to Stop Bleeding

A patient had a TAVR procedure and had continued bleeding of the femoral artery, so a femoral artery stent was deployed. What code do I use for this service? I see that the CPT book states, "Codes 37220-37235 are to be used to describe lower extremity endovascular revascularization services performed for occlusive disease," so I know that these codes do not apply since the stent was deployed for hemostasis. Is this a billable service?

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Posted in Free Newsletters By Sondra Dunn

September 2016 Q & A

Question: Brachial Cutdown Not Involving AAA Repair

I have used 34834 for a brachial artery cutdown for AAA repair. Can you please advise on CPT Code for cutdown of brachial artery for repair of SFA aneurysm with a Viabahn Stent?

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - August 2016

Aug 30, 2016 2:20:00 PM

August 2016 Q & A

Question: Embolization - 37241 for lymphatic malformation treatment

How do I code the following?
PROCEDURE: The left axillary lymphatic malformation was examined with ultrasound and a suitable access site for needle placement was identified and the skin marked. The left axilla was prepared and draped in the usual sterile fashion. Using ultrasound guidance the first site (site #1) in the deep aspect of the axillary region was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Next, using ultrasound guidance, the second, more superficial site (segment #2) was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Finally, a superficial collection (site #3) was accessed with a 21-gauge micropuncture needle through which direct injection of 2 mL of doxycycline was performed. The predominant injection solution composed of a 4:1 dilution of doxycycline (10 mg/mL): Omnipaque 300 was injected under ultrasound and fluoroscopic guidance, according to the following outline: A total of 160 mg doxycycline in 16 mL saline was injected.

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - July 2016

Jul 29, 2016 2:20:00 PM

July 2016 Q & A

Question: Does a CTO 92943 have to be staged?

Since a CTO is a CHRONIC total occlusion, does it need to be staged? They would know about it ahead of time, since it is chronic. But what if the doctor finds a CTO upon first diagnostic angiography, and is able to treat it with some type of intervention at that same session? Would that be billed as a 92943 along with the cardiac cath code (w/59)? Or, because it is the first time it was found, is the PCI code just the 92928, 92920, 92924, 92933 etc instead of 92943? Do we need to find prior documentation showing CTO was known about prior to intervention?

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Posted in Free Newsletters By Sondra Dunn

NCCI Changes On July 1, 2016

Jul 5, 2016 6:09:00 AM

National Correct Coding Initiative (NCCI) Changes On July 1, 2016

We’ve just entered a new calendar quarter, so the NCCI edits are revised.

There are numerous changes, which we’ve posted for members under the 'Newsletters' section. Here are some examples:

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Posted in Free Newsletters By Sondra Dunn

CPT® 2016: Neuro-interventional Coding

Jun 30, 2016 6:09:00 AM

CPT® 2016: Neuro-interventional Coding

Part 3: Understand the changes affecting neuro-interventional procedures.

For 2016, the biggest CPT® coding changes affecting interventional radiology occur within the subspecialties of urinary, biliary, and
neurologic intervention. In March, we covered urinary intervention and in April we covered percutaneous biliary interventional coding. This month, we’ll finish our series by focusing on transcatheter neuro-interventions and describing three new codes for 2016.

Read the whole article.

Originally presented in "Healthcare Business Monthly".

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - June 2016

Jun 26, 2016 2:20:00 PM

June 2016 Q & A

Question: Upper Extremity Angiography with Thoracic Aortography

Using direct ultrasound guidance, the right common femoral artery was accessed with a micropuncture needle. Through this access, a 5 French sheath was placed. A flush catheter was advanced into the ascending thoracic aorta. Aortography was performed. 5 French catheter and wire were advanced into the left subclavian artery. Arteriography was performed. There was poor visualization of the arteries beyond the fistula anastomosis. 36215-59 for subclavian, 36221 for thoracic aortogram?
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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - May 2016 #2

May 29, 2016 2:20:00 PM

May 2016 Q & A #2

Question: Drug Coated Balloons

When doing an angioplasty with the drug coated balloons, do you bill the procedure as an angioplasty or artherectomy?
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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - May 2016

May 25, 2016 2:20:00 PM

May 2016 Q & A

Question: Angioplasty of the iliac with the sheath?

Can we bill 37220 for an angioplasty of the iliac artery with the sheath? I don't think so, but I just wanted to double check because the CPT description does not use the word "balloon".
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Posted in Free Newsletters By Sondra Dunn

CPT® 2016: Percutaneous Biliary Interventional Coding

Part 2: New codes change the way you should report these procedures.

For 2016, the biggest CPT® coding changes affecting interventional radiology occur within the subspecialties of urinary, biliary, and neurologic intervention. Last month, we covered urinary intervention. This month, we’ll discuss the major changes in percutaneous biliary interventional coding. Next month, we’ll cover CPT® updates for percutaneous neurologic intervention.

Read the whole article.

Originally presented in "Healthcare Business Monthly".

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Posted in Free Newsletters By Sondra Dunn

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