Items Tagged: intervention



ZHealth Coding Update - Retroactive Billing Medicare

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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ZHealth Coding Newsletter - March 2017

March 2017 Q & A

Question: Treating Tibioperoneal Trunk with PTA and SFA

I have heard that it may be possible to code for an intervention in the tibioperoneal trunk in the following two scenarios: 1. It is the only vessel treated; 2. It is separately treated in addition to an intervention in the anterior tibial artery. My patient has focal stenoses of the mid and distal SFA treated with angioplasty. A patent popliteal artery. Focal high grade stenoses in the superior aspect of the tibioperoneal trunk and within the distal tibioperoneal trunk at the bifurcation of the peroneal and tibial artery. These stenoses were treated with angioplasty as well.

Can I report code 37228 for the tibioperoneal trunk in addition to the SFA angioplasty (37224)? I'm a bit confused because the CPT code book indicates the tibioperoneal trunk would be considered part of the tibial/peroneal territory, but not a separate 4th segment of vessel. Does this mean if it is the only segment of vessels in the tibial/peroneal territory it is billed? Even if another territory is billed? 


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ZHealth Coding Newsletter - July 2016

July 2016 Q & A

Question: Does a CTO 92943 have to be staged?

Since a CTO is a CHRONIC total occlusion, does it need to be staged? They would know about it ahead of time, since it is chronic. But what if the doctor finds a CTO upon first diagnostic angiography, and is able to treat it with some type of intervention at that same session? Would that be billed as a 92943 along with the cardiac cath code (w/59)? Or, because it is the first time it was found, is the PCI code just the 92928, 92920, 92924, 92933 etc instead of 92943? Do we need to find prior documentation showing CTO was known about prior to intervention?

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