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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

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 - 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?

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Posted in Free Newsletters By Sondra Dunn

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