ZHealth News

Special Edition Newsletter: Moderate Sedation

Revision to 'Professional Billing of Moderate Sedation by the Physician Performing the Procedure When in a Facility Site of Service'

The codes for reporting moderate sedation performed by a physician or other qualified health care professional other than the one performing the procedure do not have different RVUs for the facility and non-facility sites of service. The RVUs are the same. There is also an NA in the NON-FAC NA INDICATOR column of the RVU file. From the CMS document explaining the NA in this field: An “NA” in this field indicates that this procedure is rarely or never performed in the non-facility setting.

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

Q & A with Dr. David Zielske

Question: Sclerotherapy for Lymphatic Malformations

In the past, the coding recommendation for direct sclerotherapy/embolization of lymphatic malformations was to use unlisted codes. With the new embolization codes for 2014, would 37241 be a possibility for these procedures? I looked at 37244 but since that is referring to extravasation, it doesn't appear to match the intent of the sclerotherapy/embolization. Although 37241 doesn't use the term lymphatics, both the CPT book and CPT Insiders refer to these embolization codes to be used when "arteries, veins, and lymphatics may all be the target of embolization". Would you recommend continuing to use the unlisted codes or using one of the 2014 codes?

Read More
Posted in Free Newsletters By Sondra Dunn

4 Item(s)

Set Descending Direction