ZHealth News

September 2017 Q & A

Question: Limbs AV Fistula Declot & Stenting Failure; TPA and Repeat Stent for Extravasation

AV left forearm graft fistulogram showed extensive thrombus in main draining vein up to the level of the distal third of the humerus. Crossing sheaths placed. Angiojet catheter used to treat arterial and venous anastamosis. It worked for arterial but not venous. Angioplasty of arterial anastomosis, with arterial flow re-established. Stent was placed across venous anastamosis to improve outflow. Patient continued to clot despite administration of 10,000 units of heparin during the procedure. Multiple passes again made with the angiojet. Flow was not re-established.

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - August 2017

Aug 28, 2017 2:22:00 AM

August 2017 Q & A

Question: Repair of EVAR with Deployment of 2 Gore Excluder Limbs

This patient developed a type III endoleak due to component separation of the left iliac limb from a prior EVAR. To repair this, our physicians first used an Excluder limb across both graft defects followed by a second Excluder limb in the patient's iliac, to bridge the separation of components. I would normally code this with 34825, 75953.

However, I am not sure how to code for a second graft in this case or if I can code for it at all because I am not positive that the second graft is considered a separate vessel and qualifies for the 34826. There is no mention of it being placed in either the external or internal iliac.


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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - July 2017

Jul 30, 2017 2:22:00 AM

July 2017 Q & A

Question: Superior Mesenteric Artery to Rt Hepatic Artery

A 5 Fr sheath was placed and attached to a heparinized saline infusion. Exchange was made for a SOS catheter and selective DSA performed in the superior mesenteric artery. Superselective catheterization of the replaced right hepatic artery was then performed using a 3 Fr Progreat Microcatheter and wire. Can a catheter reach the right hepatic artery from the SMA or does the catheter need to go through the celiac artery?

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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

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

CPT® 2016: Urinary Interventional Coding

Part 1: Understand what changes affect percutaneous urinary interventional coding.

For 2016, the biggest CPT® coding changes affecting interventional radiology occur within the subspecialties of urinary, biliary, and
neurologic intervention. This month, let’s focus on percutaneous urinary interventional coding, and in upcoming articles we’ll cover biliary and neurologic intervention codes.

Read the whole article.

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Posted in Free Newsletters By Sondra Dunn

November 2015 Q & A

Question: Upgrade from Dual Pacemaker to BiV AICD

The upgrade to a biV AICD from a dual pacer leads me to CPT codes 33230, 33233, and 33225. But this scenario is very confusing because the descriptor for 33230 says "with existing dual leads", so should I use 33231 because now with the addition of the LV lead that was implanted along with the BiV generator,  I have 3 total leads?

 

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - July 2015

Jul 28, 2015 1:20:00 PM

July 2015 Q & A

Question: 2 Infusion Catheters, 2 Graft Punctures for Access of the Same Leg

The patient has a left femoral to below-knee popliteal artery bypass graft and a left abandoned bypass graft. A micropuncture needle was advanced in a midline retrograde fashion and a sheath placed. A pelvic angiogram shows occlusion of the bypass graft and a 10 cm infusion Cragg-McNamara infusion catheter is placed and positioned across the proximal arterial anastomosis. Then under direct ultrasound guidance, a micropuncture needle was advanced into the proximal graft in an antegrade fashion, then a sheath was placed, followed by lower extremity angiography.

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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

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