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  1. R

    Wiki Right above the knee amputation revision with sinus tract excision

    Would it just be a debridement?
  2. R

    Wiki Right above the knee amputation revision with sinus tract excision

    Right above the knee amputation revision with sinus tract excision including skin ellipse (6cm x 2cm) Pt developed a skin opening in the right above knee amputation stump. Sinus tract has previously healed but appears to be recurring. The sinus tract opening was inspected and spread open. No...
  3. R

    Wiki Metatarsal #5 resection

    If any part of the metatarsal (even part of the metatarsal head), you would code each with 28810 and the appropriate digit modifiers. (Source: https://www.zhealthpublishing.com )
  4. R

    Wiki Iliac Artery to Profunda artery bypass

    MD did a Iliac Artery to Profunda artery bypass by harvesting ipilateral superficial femoral artery. I can't find a code for LE artery harvest. Does anyone know how to code this?
  5. R

    Wiki Adenosine - heart cath procedure

    The NCCI Provider Policy Manual states the following: "The global surgical package includes the administration of fluids and drugs during the operative procedure. CPT codes 96360-96376 should not be reported separately. Under OPPS, the administration of fluids and drugs during or for an...
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    Wiki HELP PLEASE! IV Pushes with Moderate Sedation

    Does anyone know...for example in an in-office cath lab?
  7. R

    Wiki Bilateral Common iliac and IVC AFX Endologix endograft

    I've only every seen Endograft with iliac limbs done in the Aorta and common iliac arteries. What code set do we use when this in the in the IVC and iliac veins?? Dx is thrombosis and stenosis. Procedure: 1.Percutaneous mechanical thrombectomy (14 x 100 Abre stent) 2.Right common iliac vein...
  8. R

    Wiki Below Knee Amputation and myocutaneous flap closure

    Is a Myocutaneous flap closure (15738) separately billable when down with a BKA?
  9. R

    Wiki Revision AVF aneurysms and artegraft placement

    What if the Aneurysm is dissected out of AVF and AVG is placed using the same artery but but a new/different vein ?
  10. R

    Wiki Forearm blood vessel repair

    I found guidelines in Dr. Z guidebook that says for this code, all vessels are coded separately. So both would be coded
  11. R

    Wiki Forearm blood vessel repair

    I think it has an MUE of 2 because there are two arms. IF you could code all four vessels wouldn't it have an MUE of 4?
  12. R

    Wiki Forearm blood vessel repair

    Sorry, I should have said the repair was the main surgery. The patient had a injury to the forearm and both arteries were completed transected. He did an embolectomy in the process. I'm just wondering about the number of times the 35206 would be billed. Does it included both arteries?
  13. R

    Wiki Forearm blood vessel repair

    If both the radial and ulnar arteries are repaired is 35206 coded twice or just once? Same incision. Pt also had embolectomy of ulnar artery. Thanks for your help!
  14. R

    Wiki Lower Extremity Cath Placement and Revascularization

    Catheter placement happens on the left, he moves it over to the right side for intervention and angiogram . This is pretty typical. My question is about moving past the point of intervention into a different vascular family in the same leg.
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    Wiki Lower Extremity Cath Placement and Revascularization

    The catheter placmeent would be the same side as the revascularization, just beyond the intervention performed. The cath access is almost always on the contralateral side.
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    Wiki Lower Extremity Cath Placement and Revascularization

    Dr. Z question ID # 4035 Question: If the right CFA is accessed , cath goes up and over the left SFA and images, then pull back to the right iliac and fix- do I get to code my 3rd order cath placement for left SFA via RCFA?+ Answer: Yes, you can report 36247-59. This was answered in 2012...
  17. R

    Wiki In-Suite Cath labs and heparin

    Thank you!
  18. R

    Wiki In-Suite Cath labs and heparin

    For in-office lower extremity cases, MD uses Versed, Fentanyl and heparin. Is the heparin billable?
  19. R

    Wiki Wound care and debridement

    I'm confused over 110042-110047 vs 97597-98. When do know to use 97597 over 11043 for example. Wound vac and and pulse lavage were used, also Thanks, Robbin
  20. R

    Wiki Ostectomy Metatarsal head and proximal phalanx coding help?

    Why are you adding the modifier 59? Was it done on a different toe? Different surgery session? By a different doctor? There needs to be a reason, you can't just add a 59 and bypass the edit because 59 is allowed on the code.
  21. R

    Wiki Can 75774 be coded here?

    Catheter placed in right common femoral and imaged saved. Angiography performed which confirmed placement in the CF. A catheter was directed into the aorta to the level of the renal arteries, and an angiography of the aorta was performed. The catheter was manipulated down to the level of the...
  22. R

    Wiki 93568 and 93567

    Does he give you the LVED pressure reading? I'm thinking 93460 93567
  23. R

    Wiki Morning angina

    I25.119, CAD with unspecified angina. The morning is just when they have it.
  24. R

    Wiki STEMI

    It sounds like he put two stents into the LM. If so, you can only code that once with 92941.
  25. R

    Wiki RHC bundling?

    What was the medical necessity of the RHC?
  26. R

    Wiki Need help - coding 75820 upper extremity venogram

    I believe it is inclusive to the pacer implant.
  27. R

    Wiki Stress test using bruce protocol at the hospital...

    93016, 93018. Your MD can only bill for the supervision and interpretation and report. 93015 is the global code. Since it was done in the hosp, they will bill for the technical portion. If it has been done in the MDs office, he would be able to bill 93015.
  28. R

    Wiki Stent graft for RCA for coronary aneurysm.

    I'm trying to get to the right codes for stent graft placement in RCA for coronary aneurysm. I know it's not the usual stent codes 92928 etc....but can't remember/find which ones to use.
  29. R

    Wiki Stent graft RCA for aneurysm

    I'm trying to get to the right codes for stent graft placement in RCA for coronary aneurysm. I know it's not the usual stent codes 92928 etc....but can't remember/find which ones to use.
  30. R

    Wiki Shock Wave lithotripsy for Lower Extremity

    Does anyone know how to code this new procedure? Thanks!
  31. R

    Wiki Brachial artery cutdown during angiography

    Pt had a brachial artery cutdown for a abdominal and right leg angiography. Catheter went to the Right Common femoral and intervention could not be done due to a long enough catheter not being available. Is this cutdown separately report and if so with what codes? Been looking into this for a...
  32. R

    Wiki Toe Debridement and Amputation

    Thanks
  33. R

    Wiki Toe Debridement and Amputation

    The right foot wound on the planter aspect of the distal 4th and 5th metatarsal was excisionally, sharply debrided to remove all non-viable dermis, tissue, muscle, tendon, bone using a scalpel, scissors and forceps. An oscillating bone saw was used to remove the distal metatarsal head and shaft...
  34. R

    Wiki Renal angioplasty

    Thank you!
  35. R

    Wiki Renal angioplasty

    Pt had a left renal artery stenosis. Catheter selected and engaged in the left renal artery (first-order). Then patient has angioplasty of renal artery. Is this coded as 37246 36251 ??
  36. R

    Wiki Central SVC angioplsty thru sheath in Internal Jugular in (HD cath)

    Pt has a HD catheter in right internal jugular vein: The area of the tunneled catheter skin exit site was infiltrated with local anesthetic. Under fluoroscopic guidance as stiff angled Glidewire was place into each catheter lumen and positioned into the IVC. The old catheter was removed. A 10...
  37. R

    Wiki EVAR with renal stent

    Thank you!
  38. R

    Wiki 99072 New Code

    Its not on the CMS fee schedule yet.
  39. R

    Wiki EVAR with renal stent

    Yes, he placed the extension in the abd aorta above the renal arteries. It then encroached on the renal artery and a stent was placed. The renal stent code would be included?
  40. R

    Wiki EVAR with renal stent

    I would think it would be the opposite....extension is coded but renal stent is not since stent appear to be in the treatment zone.
  41. R

    Wiki Revision AVF aneurysms and artegraft placement

    Thank you very much!
  42. R

    Wiki Help with Toe amputation an Flap closure

    Thanks!!
  43. R

    Wiki EVAR with renal stent

    Pt had a typical Aortic-bi-iliac Endograft placed (34705) then angiogram showed Type 1 endoleak. Then 6 EndoAnchors were deployed ( 34712). Repeat angio still showed Type I endoleak. At this point, he marked the renal artery and deployed a 34x34x52 cuff creating them 2 to 3 mm above the prior...
  44. R

    Wiki Help with Toe amputation an Flap closure

    Thanks. So no 14040 either?
  45. R

    Wiki Help with Toe amputation an Flap closure

    Procedure: Left Hallux partial amputation Myocutaneous flap closure of left hallux amputation site Elliptical incision around the distal end of the hallux where the initial dorsal injection went across the top of the 5th toe transversely just proximal to the nail plate. Then the incision...
  46. R

    Wiki Revision AVF aneurysms and artegraft placement

    Pt has a bleeding AVF aneurysms. They go in for a revision of AVF( resection aneurysms, and Artegraft placement) Is this all covered under the revision code or can the AVG placement be additionally coded? "The AVF was dissected an sharp scissors were used to resect the aneurysmal portion and...
  47. R

    Wiki Open Thrombectomy--2 times one session

    Thank you!
  48. R

    Wiki Open Thrombectomy--2 times one session

    Pt has a open thrombectomy of Popliteal, AT and PT. Pretty normal procedure. Surgery complete and patient is closed. Before they leave the room, it is noticed the signal is completely gone. Pt had to be reintubated, re-prepped, re-opened and the same procedure repeated. Again Thrombectomy of...
  49. R

    Wiki AVG Help- What all can I code here?

    Thanks!
  50. R

    Wiki Axillary to femoral bypass and thrombectomy of PT artery

    That's what I ended up going with ! Thanks!
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