ZHealth News

November 2017 Q & A

Question: Infrarenal AAA

My provider did infrarenal AAA, using US guidance, he accessed both femoral arteries. He deployed a Gore endovascular stent with careful attention not to encroach the left renal artery. Then, the Gore limb was placed into the right common iliac artery. An extender device was placed from the main body limb, just above the left hypogastric. My question: is it appropriate to code 34825 since he used another limb extension?

Read More
Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - June 2017

Jun 29, 2017 2:22:00 AM

June 2017 Q & A

Question: Coarctation of Aorta and Bicuspid Aorta Valve

I have a provider that is is trying to tell us that if a patient has a coarctation of the aorta and a bicuspid valve then we need to bill the congenital CPT codes. I noticed that you answered a similar question in March, but I was wondering where you got your information so I can provide that information to my provider.

Read More
Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - March 2016

Mar 30, 2016 2:20:00 PM

March 2016 Q & A

Question: Angioplasty or Primary Thrombectomy with No Stenosis Documented

Patient is on Day 2 of lower extremity arterial thrombolysis with EKOS catheter. The patient was placed on the angio table and the catheter was injected showing significant residual heavy clot burden. The physician ballooned the thrombus in the anterior tibial, posterior tibial and peroneal arteries with a 3mm balloon, then used an aspiration catheter in each vessel post ballooning due to loose clot seen within these vessels. There is no physician documentation of any underlying anatomical stenosis in these vessels. Thrombolysis was restarted with the EKOS catheter and sent to the floor for overnight monitoring. On Day 3, the patient is brought back for AngioJet thrombectomy, repeat ballooning of the peroneal along with thrombolytic spray through the AngioJet for 20 min. This is repeated in the posterior tibial artery. Follow-up angiography demonstrates a flow limiting dissection requiring stent placement.

Day 2 was coded as ...

Read More
Posted in Free Newsletters By Sondra Dunn

October 2015 Q & A

Question: When do you use 75630 vs 75625

I am completely confused on Abdominal Aortic imaging. Does CPT code 75625 require 2 catheter placements or not? For example, physician places a catheter in the abdominal aorta near the renal arteries and performs abdominal aortography, also documents bilateral pelvic and common femoral artery imaging. The physician then moves the catheter to the SFA and completes the angiography with chase bolus runoff to the foot on the left. Is this coded as 36247, 75625, 75716 or is it 36247, 75630?

Read More
Posted in Free Newsletters By Sondra Dunn

September 2015 Q & A

Question: 36228 with Pipeline Embolization

Following diagnostic cerebral angiogram with bilateral internal carotid artery catheter and 3D angiogram requiring separate work station, angle projections for treatment of the cavernous segment of the right internal carotid artery aneurysm were obtained. Navien catheter was positioned within the intracranial segment of the right internal carotid artery, and Marksman catheter was navigated into the right middle cerebral artery. Then pipeline embolization was done on the right cavernous carotid segment. At the completion of the coiling procedure, cerebral angiogram was performed via the right internal carotid artery. Besides 36224-50, can I add 36228 in this case even though the embolization was at cavernous carotid? I also coded 61624, 75894, 75898, and 76377. Are these the right codes for this case?

Read More
Posted in Free Newsletters 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?

Read More
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.

 

Read More
Posted in Free Newsletters By Sondra Dunn

7 Item(s)

Set Descending Direction