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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

September 2014 Q & A

Question: Vertebral Artery Stenting

Rt. vertebral artery origin has severe flow-limiting stenosis at level of C-6 and intracranially 50% and 40%. Procedure codes used are 0075T, 76937 x2, G0269, 36140. Impression: Rt. vertebral artery origin severe stenosis reduced to minimal residual after balloon mounted stent placement. Basilar artery flow is improved with lower blood pressure after the intra-arterial administration of vasodilator and rt. vertebral artery origin stent placement. Lt. superficial femoral artery arterial monitoring catheter placement.

Medicare is denying 0075T for modifier incompatibility. ...

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Posted in Free Newsletters By Sondra Dunn

Job Posting

Sep 17, 2014 10:09:54 AM


St. David’s Healthcare
Austin, TX

Recruiting for local, experienced coder to work in the Charge Compliance Unit. CIRCC certification preferred. This salaried position will be reporting to the Division Revenue Compliance Director. Qualified candidates may contact Ms. Penny Garcia directly at 512-656-2376/penny.garcia@stdavids.com

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Posted in News By Charlene Kennedy

ZHealth Coding Newsletter - August 2014

Aug 25, 2014 2:58:00 PM

August 2014 Q & A

Question: Liver biopsy with tornado coil placement

Physician performed a percutaneous needle core biopsy of the liver using ultrasound guidance (47000 &76942). At the end of his dictation for the biopsy, he said "An introducing needle was then placed into the lesion. An 8x4 tornado coil was placed through the introducing needle." Can I code for this coil placement, and if so, what code(s) would I use?

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Posted in Free Newsletters By Sondra Dunn

Effective January 1, 2015, CMS is implementing four new HCPCS code modifiers to replace modifier -59, a modifier used to define a “Distinct Procedural Service.”

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Posted in News By Sondra Dunn

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