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  1. J

    Wiki Resection of xiphoid process

    Would this be 21620? The provider chose 21630 but not sure that's right? The patient's identity and planned procedure verified, and the patient was placed on the operating room table in the supine position. The patient was prepped and draped in the standard fashion. An small midline incision...
  2. J

    Wiki Sealing of coronary aneurysm with vascular plug

    Any ideas on code for this? Will I have to use unlisted? 1. Sealing of a large coronary aneurysm with a vascular plug. He was admitted to the hospital a few days ago with sepsis. He was found to have an elevated troponin. An echo showed preserved left ventricular function but there was...
  3. J

    Wiki Sealing aneurysm with vascular plug

    I haven't seen this before. Any idea on cpt to use for this? PROCEDURES: 1. Sealing of a large coronary aneurysm with a vascular plug. DETAILS OF PROCEDURE: Local anesthesia was attained in the right groin. A 6-French long sheath was placed in the right femoral artery. An angiogram was...
  4. J

    Wiki Coronary Sinus Venography

    Is there a code for coronary sinus venography? What should I use if anything? It was done during an ablation.... Given our lack of response on the left side, we then pulled back to the right atrium. We positioned the Agilis into the coronary sinus and performed coronary sinus venography...
  5. J

    Wiki Pericardial drain removal

    Is there a cpt code for pericardial drain removal? I am not finding one. Wondering if the removal is included in the insertion of it? Please advise. Thanks, Jessica C
  6. J

    Wiki Pulmonary angiogram/thrombectomy

    Hi All, Can you please help me with this portion of a cardiac catheterization note? I have ideas on codes but want to put question out there because I'm not 100%. First time I've seen this done with cath: PULMONARY ANGIOGRAM DATA: The pulmonary angiogram was performed with 5-French pigtail...
  7. J

    Wiki Clinical Trial Number????

    Hi, I rec'd a denial from UHC Medicare Complete for carotid stenting, cpt 37215, stating "missing clinical trial information". I've coded this procedure out a handful of times without clinical trial number and never had any issues. I'm aware that this is an inpatient procedure but that's really...
  8. J

    Wiki Lengthy Peripheral study-need help!

    OK, would someone please be willing to read this and let me know about codes? I have: 93454.26 36221 92928.RC 92978.26.RC 75710.26 I'm stuck on the rest. Could the 35475/75962.26 be used for PTA of radial artery? Any catheter placement code I may be missing? Uggh, this one was a doozy for me...
    • Jess1125
    • Thread
    • artery patient radial sheath spasm
    • Replies: 1
    • Forum: Cardiology
  9. J

    Wiki Denial - I got a denial from Anthem here

    Hi there, I got a denial from Anthem here. I'm pretty sure this will just have to be appealed but wanted to be sure. Codes billed: 93620.26 93621.26 93286.26.59 x2 33233 33249 93641.26 Basically we have an EP study followed by upgrade of a dual pacemaker to a dual ICD. Anthem paid for all...
  10. J

    Wiki Adenosine study during cath

    Hi all, I'm pretty sure this isn't separately billable at all but wanted to be sure before I put the charges for the cath through. (Billing physician side so just professional portion...) Appears to be a pharmacologic cardioversion I thought. INDICATION FOR STUDY: Atrial arrhythmia...
  11. J

    Wiki Temporary Pacemaker

    I've never seen this before. Provider did a repositioning of a temporary pacemaker. Do I bill anything for this? Use unlisted cardiovascular procedure? Jessica CPC, CCC
  12. J

    Wiki Cardioversion and pacemaker

    Please lend your two cents. I've been trying to find info but haven't had luck. A cardioversion was performed during a pacemaker insertion procedure. Modifier -59 is allowed but I don't know if this should've been billed out or not separately. PROCEDURES PERFORMED: 1. Dual-chamber...
  13. J

    Wiki More than your typical peripheral intervention

    Looking for guidance please. This wasn't your typical peripheral intervention. Wondering about any other ideas for coding besides the 37226. Can anything else be coded??? Do want to note that this WASN'T a diagnostic study. Patient came in specifically FOR the intervention. INDICATIONS FOR...
  14. J

    Wiki Pacemaker - Just received a denial from Medicare

    Just received a denial from Medicare for the following procedure and just want to make sure this was coded correctly as I'm pretty sure it is but I'm throwing this out there anyway! PROCEDURES PERFORMED: 1. Placement of a single chamber pacemaker. 2. Relocation of a pacemaker pocket. 3...
  15. J

    Wiki 93464-26

    Hello all. I know I have 93453-26 and 93463-26 here but wondering if I should be doing the 93464-26 as well? Provider didn't circle it on the route. PROCEDURES PERFORMED: 1. Left heart catheterization. 2. Right heart catheterization. 3. Dobutamine and exercise challenge. PROCEDURE IN...
  16. J

    Wiki EP question

    Any idea on what code to use for non-invasive programmed stimulation portion of this procedure? PROCEDURES PERFORMED: 1. Noninvasive programmed stimulation (NIPS). 2. Removal of a pacemaker generator. 3. Placement of ICD lead and dual-chamber ICD generator. PREOPERATIVE DIAGNOSES: 1...
  17. J

    Wiki Would you code...

    INDICATIONS FOR STUDY: History of coronary artery disease, abnormal echo, attempt to cardiac catheterization and peripheral vascular disease. STUDIES PERFORMED: Selective left and right external iliac angiogram. PROCEDURE DATA: Left groin was anesthetized with 2% Lidocaine. Subsequently...
  18. J

    Wiki HELP w/ EP case

    I have a case that I knew would come back to haunt me and it indeed did. Please help me with what is the correct billing. Sorry, this may be lengthy but I have questions! INDICATIONS FOR SURGERY: The patient is a 61-year-old woman with a history of cardiac arrest and nonischemic cardiomyopathy...
  19. J

    Wiki Number?

    Hi there, I'm under the impression that for Medicare when we submit claims for an ICD that was implanted for primary prevention purposes and we attach a -Q0 modifier to 33249 that we now have to put on the claim the clinical trial identifier number. Any idea as to what that number is? I'm not...
  20. J

    Wiki 0075t - My provider did an aortic

    Anyone familiar with this at all? This is my first time utilizing this code for vertebral artery stenting. My provider did an aortic arch study with this. I realize the catheter placement in the vertebral artery as well as the radiological images would be included but not sure about the arch...
  21. J

    Wiki Sinus node modification

    What would be a possible cpt code for above? I don't have a procedure note yet or anything. I got an email from the person who does the Cardiology precerts asking for a code as this is scheduled. This wouldn't be 93650 would it? Jessica CPC, CCC
  22. J

    Wiki EP question-I need help

    Okay, I need help from someone more experienced with EP than I currently am. Our EP provider has been here a year almost and I still need help at times with this. He has a question and I don't know the answer. Provider did atrial overdrive pacing of patient's SVT which he thought would count...
  23. J

    Wiki Generator change

    OK, I'm pretty certain I know the answer but wanted to be sure! Patient going into the procedure had a dual chamber pacemaker system. Generator was at end of life, ERI and was referred for pulse generator change. Her atrial lead was capped as it has been programmed off. I imagine I would bill...
  24. J

    Wiki Correct codes?

    Please read below. In this case would it be 33207 and 33233 being billed? Thanks in advance: PROCEDURE PERFORMED: 1. Placement of an RV pacing lead. 2. Removal of pacing pulse generator with replacement of a dual-lead pulse generator. PREOPERATIVE DIAGNOSES: 1. History of bradycardia with...
  25. J

    Wiki 33225 + ?

    Okay, The patient I'm working on had a single chamber ICD and was brought in for an upgrade to a Bi-V ICD. The existing RV lead was left in place and a new LV lead was inserted as well as the old generator explanted and a new one placed. I know to report the 33225 but I'm wondering about the...
  26. J

    Wiki CRT pacing under echo guidance.

    Okay, I feel I've read about this before but can't find anything. Does anyone know how the above would be coded? I have a couple patients who had echos done as part of CRT optimization. Would I code out a limited echo along with a device interrrogation code? Please help me and refer me to...
  27. J

    Wiki Have you seen this?

    What a great day this is! Has anyone seen this? I know I've been dealing with the below issue for the last year and am so glad it is being fixed... http://www.cardiosource.org/Practice-Management/Working-With-Health-Plans/McKesson.aspx Jessica CPC, CCC
  28. J

    Wiki Advice please-EP study

    Hi, I'm reading my first ever EP study and unfortunately, I don't feel I can pick out the parts from this note. Does the provider need to do better documentation? Or is his documentation okay and I just need to learn what in this report is telling me these codes are supported? Provider billed...
  29. J

    Wiki What do you think

    I have a different situation here and not sure how to go about coding it. Basically the plan was to put in a single chamber ICD. Patient had a cardiac arrest on the table. The provider already had the ICD lead open so he put that in but then put in a pacemaker pulse generator. I can't use the...
  30. J

    Wiki Dx code

    What dx code are you using for an ICD lead that was recalled that they are checking on? Thanks. Jessica CPC, CCC
  31. J

    Wiki Upgrade to ICD help

    Okay, I got my first electrophysiologist this month and I'm learning here. Please help me with the following procedure note: PROCEDURES PERFORMED: 1. Left upper extremity venogram. 2. Removal of the patient's pacemaker pulse generator. 3. Placement of an ICD lead. 4. Placement of an...
  32. J

    Wiki Tilt table test - I'm totally new at this EP stuff

    Okay, I'm totally new at this EP stuff. We just got our clinic's first electrophysiologist this week. He did a tilt table test and I know the code is 93660.26. Is it typical to bill the 36620 along with that? I thought maybe we would but I'm not finding anything online about it. Jessica CPC, CCC
  33. J

    Wiki 75574

    Does anyone know the following? I've been asked this by someone in administration to look into. Does cpt code 75574 include looking at the aortic arch? I don't think the aortic arch is part of this. I see comments on the aorta but not the arch specifically in these reports. What if the...
  34. J

    Wiki Anything else here?

    Hi, I have a report for a Swan Ganz catheter placement which I don't have a problem with. He also said he placed a right internal jugular central venous line but not really familiar with that so wondering if he's got the right documentation and what the code would be. "The patient was...
  35. J

    Wiki Aortic sclerosis

    I have a question. I have a provider who doesn't always comment on the aorta in the findings of the echo report. As you know, that is one of the nine areas that CPT says is needed in order for this to be considered a complete echo. The thing is, though, I see the comment of "aortic sclerosis"...
  36. J

    Wiki New cath codes and modifier...

    I'm all set with the new cardiac cath codes for 2011 but have just one question... Will I be putting a -26 modifier on or not???? The cath placement, s/i codes now get a -26 but the injections don't. Now all these services are bundled into one code.... Thank you. Jessica CPC, CCC
  37. J

    Wiki Laser thrombectomy

    My provider did a laser thrombectomy of the right common femoral vein. He had done a PTA in the left femoral vein and repeat venograms were showing persistent stenosis. After this: "A 2.0 laser catheter was used to perform laser ablation at 3 different energy for multiple times. The highest...
  38. J

    Wiki Atherectomy venous

    Is there a CPT code for a percutaneous atherectomy-common femoral vein??? I see there is a venous angioplasty code but not seeing atherectomy? Am I missing it or will I have to go unlisted? Jessica CPC, CCC
  39. J

    Wiki Any ideas?

    I have something I've never ever come across before. Patient had come to the cath lab for a pacemaker insert. Under fluroscopy the electrophysiologist noticed there was a guidewire located from the superior vena cava through the left atrium into the pelvis. My provider was requested to do the...
  40. J

    Wiki Code?

    What is the code for this study? I coded a ton of nuclear stress test reports but this report is a little different. Its a thallium viability study is what the doctor wrote down. Type of exam: Thallium; Rest Only Indication: Severe coronary disease and left ventricular dysfunction. Nuclear...
  41. J

    Wiki Cooling catheter

    When the provider inserts a cooling catheter during a cardiac cath is that separately billable on the physician side at all? If so, what is the cpt code I would use? I think this cooling protocol is a new thing that hospitals are starting to do on patients who've had a cardiac arrest. I've...
  42. J

    Wiki G0248

    I'm trying to get a fee set up for G0248, Initial demonstration of the home INR monitor. Is there any code that is similar that I could maybe compare it to for pricing? Jessica C.
  43. J

    Wiki Haven't seen this before

    Good afternoon, I haven't seen this before. I had a provider circle 93510-26 on the route slip as well as a 93501-26. My initial thought was he should've circled the 93526-26. When reading the cath report I had seen that there was arterial and venous access obtained in both groins. Reading...
  44. J

    Wiki Cpt 93229

    CPT 93229 isn't on Medicare's physician fee schedule at all. What does that mean? Is this a code that I shouldn't be billing out? Thank you for any response.
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