ZHealth News

ZHealth Coding Newsletter - May 2015

May 15, 2015 7:58:00 AM

May 2015 Q & A

Question: Coding Both Bone Marrow Aspiration and Bone Marrow Core Biopsy

According to the AMA’s CPT Assistant March 2015, when both bone marrow aspiration and bone marrow biopsy of the same site are performed, we can code both 38221 and 38220. Since there is a NCCI edit between the two codes, can we use modifier -59 to override this edit? Please clarify. Thanks.

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Posted in Free Newsletters By Sondra Dunn

Job Posting

Apr 24, 2015 12:58:44 PM

POSITION AVAILABLE

Nashville, TN

Full-time coder needed for busy cardiology physician practice in Nashville, TN. Interested parties should contact Angela Whitfield at (615) 406-6305. 

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Posted in News By Morgan Teveit

ZHealth Coding Newsletter - April 2015

Apr 13, 2015 7:58:00 AM

April 2015 Q & A

Question: Pre-Procedure SIRTeX GDA Embolization with Angiograms

We routinely perform pre-procedure embolization and roadmapping prior to the SIRTeX procedure. When the GDA is embolized we are using CPT code 37242 for the embolization. Can we bill the pre-procedure roadmapping for the SIRTeX at the same time as the GDA embolization? From report: IMPRESSION: Arterial mapping and coil embolization as described above for preprocedure SIRTeX SIR-Spheres selective internal radiation therapy (SIRT).

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Posted in Free Newsletters By Sondra Dunn

New C-code Effective April 1st (C2623)

Mar 18, 2015 3:51:48 PM

New HCPCS code C2623, Catheter, transluminal angioplasty, drug-coated, non-laser, will be effective April 1, 2015.

Code C2623 is a “pass-through” code and will receive additional payment from Medicare when billed. Hospital charge description masters should be updated with this code on April 1, 2015. These catheters can cost over $2,000, so it is important for the facility to receive the additional reimbursement when these specialty catheters are used.

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Posted in News By Sondra Dunn

ZHealth Coding Newsletter - March 2015

Mar 13, 2015 7:58:00 AM

March 2015 Q & A

Question: Atherectomy of Left Arm

Could you please clarify the uses of code 0234T? The CPT description says, "transluminal peripheral atherectomy." Since there is a separate code for the brachiocephalic trunk and branches (0237T) on the right side of the body, does this mean that 0234T may be used for atherectomies in the left arm, as well as renal atherectomies?

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Posted in Free Newsletters By Sondra Dunn

February 2015 Q & A

Question: Heart Transplant - Congenital Versus Non-congenital

There has been much back and forth over the years as to whether or not congenital heart transplant patients should continue to be reported as congenital for heart catheterization coding purposes. Physicians state that “once congenital always congenital”, but I've understood from consultant recommendations that unless the new heart has a congenital defect or complex rerouting of vessels due to congenital cardiac anatomy, then all heart caths for transplant patients are coded as non-congenital. Can you please clarify?

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Posted in Free Newsletters By Sondra Dunn

January 2015 Q & A

Question: 37186 - Secondary Mechanical Thrombolysis

What is your opinion of coding 37186 as add-on with 37225 when thrombus is identified and documented in the primary atherectomy site, not in distal anatomy? Single rotational/aspiration device is used.

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Posted in Free Newsletters By Sondra Dunn

December 2014 Q & A

Question: Preoperative Tumor Embolization

The preoperative embolizations are sometimes confusing because they are done for varying reasons. When embolization is arteries supplying tumor, would this be considered Tumor Embolization? Patient has metastatic renal cell carcinoma to femur.

 

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Posted in Free Newsletters By Sondra Dunn

November 2014 Q & A

Question: IVUS Without A Base Code

I thought I read something about a change regarding IVUS without a base code. The patient has known CAD, and the only procedure done was an IVUS of the Left Main and LAD. Patient's groin prepped, 5 French sheath was placed and the guide was advanced. Wire was placed down to the LAD & IVUS of Left Main and LAD was done. I have documentation of the IVUS findings. Catheter as well as sheath were removed. IVUS would be coded as 92978 &92979, but current edits indicate a base code is needed. We don't have a base code. Was there a change so this can be coded, or is there another code that we should add, or is our claim going to be denied?

 

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Posted in Free Newsletters By Sondra Dunn

October 2014 Q & A

Question: Venous Stent Placement During Thrombolytic Therapy

In the 2014 Interventional Radiology Coding Reference, page 196 example #2, there is a thrombolytic therapy procedure that ends with a venous stent placement. The venous stenting codes do not include the catheter placement, and according to the CPT manual, you should report those in addition to the stents (37238-37229). The example only has the 37238 and does not list a catheter placement CPT code. The thrombolytic catheter is removed and a new catheter for the stent placement is inserted. Other coding references have stated that if a new catheter is placed even from the same access, you would report the catheter placement for the intervention. Wouldn’t you report the venous catheter placement in this example? And if so, what code would you use?

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Posted in Free Newsletters By Sondra Dunn

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