Recent content by fhromeo30

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    Wiki Local Coverage Articles

    My state is Hawaii (Noridian Part B) and the HCPCS code is J9035. The drug injected is bevacizumab. There are 3 articles that come up for Noridian, for bevacizumab but all 3 state this at the top of the document "Not an LCD Reference Article. This article is not in direct support of an LCD".
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    Wiki Local Coverage Articles

    My MAC is Noridian and the state does not have an active LCD. I am being told I need to follow the article that Novitas has.
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    Wiki Local Coverage Articles

    So when I search my state, I get the LCA with no LCD. Do I have to follow it? I thought the state/MAC had to have an LCD before I had to worry about following it.
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    Wiki Local Coverage Articles

    My understanding is that Local Coverage Articles are 'further explanation' of an LCD. So if a state does not have an LCD for a CPT or HCPCS code, we do not need to research further and read any Articles that apply when the same code has an LCD for a different state. For example, J9035 does not...
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    Wiki Axillary Graft for Bypass During Arch Grafting

    Thank you. Is all work associated with connecting the patient to bypass billable? (My CCVTC coder is out of office and I'm struggling with what to bill in relation to bypass)
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    Wiki Axillary Graft for Bypass During Arch Grafting

    Hello, If a graft is placed in the axillary vein to use for CardioPulmonary bypass during a total arch replacement--do we code the creation of the axillary graft? I'm thinking it is included in the primary procedure which requires bypass but I would like confirmation. After informed...
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    Wiki Diagnostic Cerebral Angiogram and Venogram

    Jim, I have a provider who is wanting me to bill an unlisted code for Dural Sinus Pressure measurements because "it needs its own code, it is additional work" . I am standing on a hard NO on this--but he is friends with Dr. Z and Dr. Z told him to bill an unlisted code. Have you billed for...
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    Wiki UHC Toradol (CPT J1885) Injection Denial

    I'm late to the party but you all are AWESOME!!! Sharing the policy with my AR team to assist with issues.
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    Wiki US Guidance 76937

    Hello, I saw another thread on this but am interested in 2019 resources or guidelines. I have read Dr. Z and the code description and would like to know how others are deciding there is enough documentation to support billing for the guidance on Heart Caths. francine cahoon, cpc, cpma, ccc, copc
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    Wiki Has anyone taken the Certification exam recently?

    I was referring to the new Ophthalmology Certification exam. Taking it tomorrow....
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    Wiki Do you agree with my Codes??? Provider doesn't

    Hi Jim Thank you--wouldnt the R Carotid Cerebral Angiogram be the 36244? Francine
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    Wiki Has anyone taken the Certification exam recently?

    I am taking the cert exam in 2 weeks... just wondered if there were any suggestions from recent test takers. I have coded ophth for 5 years. francine
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    Wiki Do you agree with my Codes??? Provider doesn't

    Under roadmap imaging after double flushing, the Envoy catheter was advanced into the proximal cervical right internal carotid artery where it was used for 3-D rotational right carotid cerebral angiography. The Envoy catheter was then connected to heparinized pressurized saline flush using a...
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    Wiki When do YOU code from a path report?

    I am looking for documentation stating when you can use the path report for diagnosis coding. I am finding things that **hint** that you can do this but I need something documented and reference-able. Any help or direction would be appreciated.
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    Wiki Mesh used as a prevention to Hernia--can I code it?

    Hi, I have a surgeon documenting that they placed mesh over the colostomy site as a prevention to hernia. Any ideas on coding for this? 49568 is for mesh during an actual hernia operation which is not what is being corrected here. Thanks in advance!
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