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.

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Posted in Free Newsletters By Sondra Dunn

January 2016 Q & A

Question: 50435 and 50693

I have a doctor that did a left nephrostogram, ureteral stent insertion and a nephrostomy tube exchange at the same setting. With the new 2016 codes, there is no scenario with a pre existing nephrostomy tract tube exchange and a placement of ureteral stent. I am getting a CCI edit for 50435 saying it shouldn't be billed with 50693. Am I missing something, or misinterpreting something? Would you bill 50693, 50435-XU? Payer is Medicare.
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Posted in Free Newsletters By Sondra Dunn

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