ZHealth News

October 2016 Q & A

Question: Femoral Stent to Stop Bleeding

A patient had a TAVR procedure and had continued bleeding of the femoral artery, so a femoral artery stent was deployed. What code do I use for this service? I see that the CPT book states, "Codes 37220-37235 are to be used to describe lower extremity endovascular revascularization services performed for occlusive disease," so I know that these codes do not apply since the stent was deployed for hemostasis. Is this a billable service?

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - August 2016

Aug 30, 2016 2:20:00 PM

August 2016 Q & A

Question: Embolization - 37241 for lymphatic malformation treatment

How do I code the following?
PROCEDURE: The left axillary lymphatic malformation was examined with ultrasound and a suitable access site for needle placement was identified and the skin marked. The left axilla was prepared and draped in the usual sterile fashion. Using ultrasound guidance the first site (site #1) in the deep aspect of the axillary region was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Next, using ultrasound guidance, the second, more superficial site (segment #2) was accessed with a trocar 6.3 French Dawson-Mueller pigtail drain. Finally, a superficial collection (site #3) was accessed with a 21-gauge micropuncture needle through which direct injection of 2 mL of doxycycline was performed. The predominant injection solution composed of a 4:1 dilution of doxycycline (10 mg/mL): Omnipaque 300 was injected under ultrasound and fluoroscopic guidance, according to the following outline: A total of 160 mg doxycycline in 16 mL saline was injected.

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Posted in Free Newsletters By Sondra Dunn

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

ZHealth Coding Newsletter - April 2015

Apr 13, 2015 7:58:00 AM

April 2015 Q & A

Question: Pre-Procedure SIRTeX GDA Embolization with Angiograms

We routinely perform pre-procedure embolization and roadmapping prior to the SIRTeX procedure. When the GDA is embolized we are using CPT code 37242 for the embolization. Can we bill the pre-procedure roadmapping for the SIRTeX at the same time as the GDA embolization? From report: IMPRESSION: Arterial mapping and coil embolization as described above for preprocedure SIRTeX SIR-Spheres selective internal radiation therapy (SIRT).

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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

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

ZHealth Coding Newsletter - May 2014

May 23, 2014 5:58:00 PM

May 2014 Q & A

Question: Yttrium-90 intrahepatic embolization, catheter placements bundled by NCCI

Under ultrasound guidance for right common femoral artery access, a catheter was advanced to abdominal aorta and on to superior mesenteric artery where an arteriogram was performed (36245-59 for catheter placement). The catheter was redirected into the celiac artery and the proper hepatic artery was selected (36247-59) where an angiogram was performed.

The catheter was then advanced into ...

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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?

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Posted in Free Newsletters By Sondra Dunn

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