ZHealth News

ZHealth Coding Newsletter - May 2017

May 28, 2017 2:22:00 AM

May 2017 Q & A

Question: 96374 with an Ablation

We had a case where Ibutilide was administered during an atrial flutter ablation procedure (93653). The Medicare claims processing manual, chapter 4, section 230.2 discusses this and says, "Hospitals should report all HCPCS codes that describe the drug administration services provided, regardless of whether or not those services are separately paid or their payment is packaged." 93653 had a "J1". 96374 has an SI of "S".

In your opinion, Ibutilide is inherent or not inherent to an ablation procedure, in which it's not always used as part of the procedure, to lets say contrast to an diagnostic angiography, is it then ok to bill 96374 for an IV push, and 96365 for an infusion, if they are given Ibutilide as part of an ablation for a flutter or A-Fib?

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Posted in Free Newsletters By Sondra Dunn

ZHealth Special Edition Newsletter

Jan 20, 2017 2:22:00 AM

Special Edition Newsletter: Moderate Sedation

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

In the physician RVU file there is a column labeled “PCTC IND” which designates when a code is technical-only or professional-only. The add-on code for each additional 15 minutes of moderate sedation by the physician performing the procedure (99153) is indicated as technical-only (3) in this field. In addition, there is an NA in the RVU file column titled “FACILITY NA INDICATOR”. The NA indicates “that this procedure is rarely or never performed in the facility setting”. Since code 99153 is technical only, a physician cannot report this code when performed in the facility setting.  

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Posted in Free Newsletters By Sondra Dunn

December 2016 Q & A

Question: Fractional Flow Reserve without Catheterization

Physician performs LHC at another facility and then transfers the patient to the cath lab at the hospital to perform fractional flow reserve (93571). The physician thinks that 93571-26-XE will get us paid by Medicare and for commercial insurance to bill coronary angiography only with 93571 to get paid.
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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - May 2016 #2

May 29, 2016 2:20:00 PM

May 2016 Q & A #2

Question: Drug Coated Balloons

When doing an angioplasty with the drug coated balloons, do you bill the procedure as an angioplasty or artherectomy?
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Posted in Free Newsletters By Sondra Dunn

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