ZHealth News

Retroactive Billing Medicare for Drug Coated Angioplasty Balloon Code C2623 with AV Dialysis Intervention Codes

Medicare is allowing pass-through payment for code C2623 with AV dialysis interventions for claims filed retroactively for dates of service from August 25, 2017, through December 31, 2017. Pass-through payment wasn’t made with this combination in 2017 due to Medicare not changing its limited coverage for the catheter’s use only in the femoral popliteal arteries. Effective January 1, 2018, pass-through payment for code C2623 ended.

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Posted in Free Newsletters By Sondra Dunn

December 2017 Q & A

Question: Drug Eluting Balloon C2623 with CPT 36902

Our facility is performing the AV angiography of the dialysis circuit as described in CPT code 36902. The surgery department is using the device code C2623 for the drug eluting balloon that is documented as being used by the surgeon. We are receiving denials that the drug eluting balloon code does not have a matching CPT code. From what I can find, it appears that drug eluting balloon code C2623 can only be used with fem/pop procedures; is this correct?

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Posted in Free Newsletters By Sondra Dunn

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?

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Posted in Free Newsletters By Sondra Dunn

October 2017 Q & A

Question: Can you bill 61635 and 61624 for the stent assisted coiling?

Diagnostic cerebral angiogram and stent-assisted coiling. Subsequently the stent was placed and unsheathed through the supraclinoid and ophthalmic segment of the ICA. DSA in AP and lateral views demonstrated optimal wall apposition. At that time the coil was introduced completely into the aneurysmal dome. Under new roadmapping a 5 x 15 hydroframe coil was introduced into the dome.

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Posted in Free Newsletters By Sondra Dunn

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

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