ZHealth News

January 2017 Q & A

Question: 32551 vs 32557

IR chest tube placement. 

Indication: Large symptomatic right pneumothorax status post CT-guided lung biopsy. 

Technique: The patient was placed supine on the fluoroscopy table. The right hemithorax was prepped and draped in a sterile fashion. The fifth and sixth rib interspace was localized with fluoroscopy, and 1% lidocaine was utilized for local anesthesia. A Cook pneumothorax 9 French drainage catheter was placed into the right pleural space using a trocar under direct fluoroscopic surveillance. The drain was then connected to a Heimlich valve, and good reexpansion of the right lung was achieved after the patient coughed. Postprocedural images demonstrate a small residual right apical pneumothorax with the drainage catheter overlying the anterior midlung zone. 

Impression: Successful placement of 9 French chest tube with satisfactory re-expansion of the right lung.

Read More
Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - April 2016

Apr 25, 2016 2:20:00 PM

April 2016 Q & A

Question: Popliteal Aneurysm

We are looking for a code for popliteal aneurysm (37236?). This is what one of our physicians said: "34900 code is an aneurysm procedure code, and although specifies iliac it is far more reflective of the procedure type and work, including large sheath placement that is involved with popliteal aneurysm repair. In fact the 2 procedures are almost identical except one is done at a more distal location." What code do you suggest we use for popliteal aneurysm and why?

Read More
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.

Read More
Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - June 2015

Jun 13, 2015 7:58:00 AM

June 2015 Q & A

Question: Balloon Dilatation and Stenting of Intrathoracic Innominate Artery

The doctor would like to charge 36217, 37218, 75710-26 for this procedure: 1. Right femoral artery cannulated in retrograde fashion. 2. Catheter into orgin of the innominate. 3. Then catheter passed selectively into the origin of the common carotid artery. 4. Then catheter selective out into the subclavian and selctive angiography was performed and confirmed subclavian widely patent. 5. Balloon dilatation performed and did not get good result. 6. Stent placed over ostial and proximal portion of innominate artery.

Read More
Posted in Free Newsletters By Sondra Dunn

October 2014 Q & A

Question: Venous Stent Placement During Thrombolytic Therapy

In the 2014 Interventional Radiology Coding Reference, page 196 example #2, there is a thrombolytic therapy procedure that ends with a venous stent placement. The venous stenting codes do not include the catheter placement, and according to the CPT manual, you should report those in addition to the stents (37238-37229). The example only has the 37238 and does not list a catheter placement CPT code. The thrombolytic catheter is removed and a new catheter for the stent placement is inserted. Other coding references have stated that if a new catheter is placed even from the same access, you would report the catheter placement for the intervention. Wouldn’t you report the venous catheter placement in this example? And if so, what code would you use?

Read More
Posted in Free Newsletters By Sondra Dunn

5 Item(s)

Set Descending Direction