Recent content by dimmitta

  1. dimmitta

    Wiki 33415 and/or 33416

    33416 is bundled into 33415 per NCCI edits. While a modifier is allowed for unbundling, this documentation does not support use of 59/x modifiers as the initial subvalvular membrane and subsequent myectomy were both performed via the same incision and are in the same anatomical area. Since the...
  2. dimmitta

    Wiki Lobectomy help

    32480 32666 vs 32608 or 32601 39402 38746 32507 Assuming you are asking someone to review the coding above? I would agree with 32480 and 39402. I don't see the coding for the cervical LN - you could consider using 38510. For the initial wedge of the RUL, I would recommend using 32668 since that...
  3. dimmitta

    Wiki Aortic arch reconstruction utilizing pulmonary artery homograft patching.

    Based on that op note above, I would agree this is 33853. This documentation - "There was clear redundancy of the aortic arch with a decreased caliber of the distal transverse aortic arch as well as isthmus." is the diagnosis to use. An isthmus is defined in medical dictionary as "a constriction...
  4. dimmitta

    Wiki Endoscopic harvest radial artery

    We are using 35600. The code description in the CPT book is "Harvest of upper extremity artery, 1 segment, for coronary artery bypass procedure (List separately in addition to code for primary procedure)." The actual code description itself does not specify this as an "open" procedure. Even...
  5. dimmitta

    Wiki Mechanical valve pannus removal.

    I would look at CPT 33496. Per CPT guidance you can also bill 33530 with this code if the valve was placed more than 1month prior to this procedure. Hope that helps!
  6. dimmitta

    Wiki Placement of Endoluminal VAC Therapy

    Hi Ellis, I have billed these before. This is a great new technique that is being done but unfortunately there are no defined codes for this yet. We use the unlisted code 43289-unlisted lap procedure, esophagus and based the pricing/RVU's on CPT codes for 43200 + 97605. Hope that helps!
  7. dimmitta

    Wiki ? left VATS with biopsy of subpleural mass

    Based on the above dictation with the biopsy being obtained in the subpleural interspace from a cyst (not nodule), I would go with 32609. I do not see any indication that a pleurodesis was performed, so definitely not 32650. Hope that helps!
  8. dimmitta

    Wiki Endoscopic Wound Vac placement

    Has anyone else seen this being performed yet? Just wondering what other people are doing to bill for this. I know it's going to have to be billed using an unlisted code but what codes are you using for comparative pricing/RVU values? INDICATION(S): Tracheoesophageal fistula A 14 French...
  9. dimmitta

    Wiki Lap Heller Myotomy, VATS/with resection of esophageal diverticulum

    There are a couple different ways you could bill the VATS esophageal diverticulectomy portion. You could look at using either 32662 (equating the diverticula as a cystic or mass like structure) or using an unlisted code and comparing it to either CPT 43135 or 43180. An argument could be made to...
  10. dimmitta

    Wiki Atrial baffle procedure (non-Mustard, non-Senning)

    Hi Andrea, I would suggest looking at 33645, as this seems to resemble a Warden procedure performed for anomalous vein drainage. Although there do seem to be a few components of the Mustard technique I agree that it doesn't match that completely. Also, I would not bill separately for the ASD...
  11. dimmitta

    Wiki Stenting of lvad outflow graft

    Stenting LVAD outflow graft Hi Patty, Sorry, I have not gotten a response from STS on this issue yet. I am still billing these as an intravascular stent placement, artery until I hear different. Wish I could be more help!
  12. dimmitta

    Wiki Stenting of lvad outflow graft

    Sorry, I know this is a late response. Not sure if you have received any other guidance on this issue since June but my physicians are doing this same thing now. Based on the documentation that my providers are giving me I am coding this with the following codes: 37236 - Transcatheter placement...
  13. dimmitta

    Wiki Help! Gerd Esophagitis and Esophageal Spasms

    Gerd esophagitis and esophageal spasms Question: Is it appropriate to code esophageal spasms as a secondary diagnosis on billing claim along with Gerd w/esophagitis? I personally believe that the esophageal spasm is trigger by the gerd reflux and is not significant to be coded since the...
  14. dimmitta

    Wiki Vats diagnostic versus therapeutic

    In 32607 the physician is taking biopsies with the primary intent to determine a diagnosis. 32607 is diagnostic and does not require attention to margins. In 32666 there is a defined mass and the purpose or intent is to provide a therapeutic treatment and would include attention to margins. Even...
  15. dimmitta

    Wiki Please help av replace - pulmon vein isolation etc

    AV replacement with Maze I would agree with all the following CPT codes based on your documentation except for 93656. I do not see that this was performed during this session, only the 33259 for the ablation. 33405 33259 33414 93656 76998 26 59 93314 26
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