ZHealth News

ZHealth Coding Newsletter - March 2018

Mar 24, 2018 11:18:00 AM

March 2018 Q & A

Question: 36904

How would you bill for crisscross infusion catheters placed in a AV dialysis fistula? Fistulogram showed thrombus within AV fistula with total occlusion. Successful crisscross placement of 5 F sheath and 10 cm infusion catheter within the venous limb directed peripherally and 6 French with 10 cm infusion catheter within the arterial limb directed centrally.

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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - July 2016

Jul 29, 2016 2:20:00 PM

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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Posted in Free Newsletters By Sondra Dunn

ZHealth Coding Newsletter - March 2016

Mar 30, 2016 2:20:00 PM

March 2016 Q & A

Question: Angioplasty or Primary Thrombectomy with No Stenosis Documented

Patient is on Day 2 of lower extremity arterial thrombolysis with EKOS catheter. The patient was placed on the angio table and the catheter was injected showing significant residual heavy clot burden. The physician ballooned the thrombus in the anterior tibial, posterior tibial and peroneal arteries with a 3mm balloon, then used an aspiration catheter in each vessel post ballooning due to loose clot seen within these vessels. There is no physician documentation of any underlying anatomical stenosis in these vessels. Thrombolysis was restarted with the EKOS catheter and sent to the floor for overnight monitoring. On Day 3, the patient is brought back for AngioJet thrombectomy, repeat ballooning of the peroneal along with thrombolytic spray through the AngioJet for 20 min. This is repeated in the posterior tibial artery. Follow-up angiography demonstrates a flow limiting dissection requiring stent placement.

Day 2 was coded as ...

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Posted in Free Newsletters By Sondra Dunn

January 2015 Q & A

Question: 37186 - Secondary Mechanical Thrombolysis

What is your opinion of coding 37186 as add-on with 37225 when thrombus is identified and documented in the primary atherectomy site, not in distal anatomy? Single rotational/aspiration device is used.

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Posted in Free Newsletters By Sondra Dunn

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