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    Wiki I42.2 vs I42.1

    My auditor wants me to use I42.1 instead of I42.2. I chose I42.2 because in the note it says she was more of a circumferential hypertrophic than a true outflow tract obstruction. PREOPERATIVE DIAGNOSIS: 1. Mitral insufficiency. 2. Patent foramen ovale. 3. Hypertrophic...
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    Wiki T82.857A

    My auditor wants me to add T82.857A. The physician documents "Prosthetic mitral valve stenosis." This should be listed as the first listed diagnosis per coding guidelines "code also." I coded this 33430 and 33530 with I34.2 and I27.20. Is she right? I was thinking for some reason that the...
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    Wiki Diagnosis I51.89 vs I51.3

    I am being audited and I used I51.89 as a diagnosis. The auditor wants me to Revise I51.89 to I51.3. She says...The physician documents under findings: "The mass appeared to be subacute thrombotic mass associated with an area in the right atrium that was fibrotic and thickened. It appeared in...
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    Wiki Auditing PA assist at surgery

    I’m being audited once again and I have a claim that I billed for the surgeon and on that same claim I billed for the AS who is a PA. So, when the auditor was listing her findings she dinged me twice. Once for the surgeon charge and again for the AS charge. They were on the same claim but only...
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    Wiki add 33362?

    PREOPERATIVE DIAGNOSIS: Acute type A aortic dissection. I coded this 33858. I am being audited and the auditor suggested that I add 33362. I think that's wrong. They didn’t do a TAVR and there isn't documentation for a TAVR. They do open the skin for the femoral artery and vein but that’s...
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    Wiki Complication Codes

    I would like to get other opinions if possible...My auditor says If a device is placed for a specific reason (in this case, the Mitra Clip and mitral regurgitation respectively), if the disease returns, it would be considered a complication since the device isn't doing it's job anymore. She...
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    Wiki CO-50 denial what am I doing wrong?

    I coded this as : 93458 - 26,59 diagnosis codes: I21.4, I25.10 92941 - LD diagnosis codes: I21.4, I25.10 92978 - 26 diagnosis codes: I21.4, I25.10 This is being denied CO-50. I'm not seeing what I'm doing wrong. Can I get some thoughts from some of you as to how you...
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    Wiki 93653 diagnosis help

    Last day of my audit! My auditor thinks that instead of using the diagnosis code I48.92 that I should use I48.3 instead. Do I have an argument? PreProcedure Dx: Symptomatic Atrial Flutter PostProcedure Dx: Symptomatic Atrial Flutter Procedures: Ultrasound guided femoral vein access SVT...
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    Wiki Pacemaker and Ablation coding question

    I have an auditor that is questioning my coding on a patient that had an ablation done and then a single chamber PM inserted. The ablation was done for atrial fib and patient developed complete heart block and pacemaker inserted. My auditor doesn't think I should use the complete heart block...
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    Wiki Z95.1 vs Z95.5

    In coding the diagnosis for this case I used Z95.5 because I thought it was the better choice because of the intracoronary stents. I'm being asked if Z95.1 would be a better choice because CABG was documented. Can someone look and give me their thoughts? I would appreciate the input. Thanks...
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    Wiki Ablation clarification

    I am trying to decide the best way to code the following report. I am considering two options. First option: 93655 x 2, 93656, 93657 x 2. Second option: 93653, 93655 x 2, 93662, 93462, 93623. My confusion or hesitation is the doctor states in the report that "pulmonary veins remained...
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    Wiki FFR

    I coded the FFR for LD but I'm unsure about the LC. Does this note show that FFR of the LC was actually done? FFR wire, Boston Scientific was utilized. Patient was started on Angiomax bolus and drip and administered 600 mg of Plavix p.o. The FFR wire was then placed down the LAD. We then...
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    Wiki Symptomatic Atrial Fibrillation

    Can someone tell me what you use for diagnosis code when it's for "symptomatic" atrial fibrillation? I was thinking of using I48.91 Thanks for your help!
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    Wiki Symptomatic Atrial Fibrillation

    Can someone tell me what code you use for "symptomatic atrial fibrillation"? I'm leaning toward I48.91 Thanks in advance for your help!
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    Wiki pacemaker

    We have a denial for using code 32100 code as incidental to primary code. I coded 32100, 33213, 33202. Anyone available to look at this and share your thoughts with me? PREOPERATIVE DIAGNOSIS: Inaccessible coronary sinus for left ventricular lead placement due to multiple previous pacemaker...
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    Wiki Diagnosis Coding3

    Could someone look at this note and tell me what they would choose to use as diagnosis? Auditor isn't agreeing with me. I used I25.10 and I27.20 INDICATIONS FOR PROCEDURE: Severe symptomatic aortic stenosis. PROCEDURES PERFORMED: 1. Nonselective left groin sheathogram. 2. 7-French sheath, left...
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    Wiki Diagnosis Coding2

    I am in discussions with my auditor and she & I disagree on the diagnosis codes for this. Can anyone else give me their opinion? I used I25.700 INDICATION FOR PROCEDURE: NSTEMI. PROCEDURE: 1. Nonselective right groin sheathogram. 2. Bilateral coronary angiography. 3. Left heart catheterization...
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    Wiki Diagnosis Coding1

    I used I25.119 and Z87.891 I didn't add N-stemi because the discharge summary stated the cause was uncertain but he did not have evidence of acute coronary episode. Would someone read the note and let me know how you would have done it? INDICATIONS FOR PROCEDURE: Non-STEMI. PROCEDURE PERFORMED...
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    Wiki Diagnosis Coding Cath4

    I used I25.119 and Z87.891 I didn't add N-stemi because the discharge summary stated the cause was uncertain but he did not have evidence of acute coronary episode. Would someone read the note and let me know how you would have done it? INDICATIONS FOR PROCEDURE: Non-STEMI. PROCEDURE...
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    Wiki Diagnosis Coding Cath3

    I am in discussions with my auditor and she & I disagree on the diagnosis codes for this. Can anyone else give me their opinion? I used I25.700 INDICATION FOR PROCEDURE: NSTEMI. PROCEDURE: 1. Nonselective right groin sheathogram. 2. Bilateral coronary angiography. 3. Left heart...
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    Wiki Diagnosis coding Cath2

    Could someone look at this note and tell me what they would choose to use as diagnosis? Auditor isn't agreeing with me. I used I25.10 and I27.20 INDICATIONS FOR PROCEDURE: Severe symptomatic aortic stenosis. PROCEDURES PERFORMED: 1. Nonselective left groin sheathogram. 2. 7-French...
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    Wiki ICD dual chamber pacemaker generator change

    I am being audited and my auditor doesn't agree with the cpt code I picked for this procedure. Could someone look at it and tell me what they would use? Thanks in advance for any help! ICD Dual Chamber Generator Change Indications ICD (implantable cardioverter-defibrillator) battery depletion...
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    Wiki Pacemaker diagnosis

    I am being audited and I'm being questioned about one of the diagnosis I used. Could someone look at this note and tell me what they would use? Thank you advance for any help! PPM Implant Biventricular Indications Complete heart block (CMS/HCC) [I44.2 (ICD-10-CM)] Pre Procedure Diagnosis...
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    Wiki CPT coding

    I am being audited and questioned about the CPT codes that I used. I used 33225, 33229, 93619. The auditor disagrees with me and I would like if someone can look and give me their opinion as to which codes are needed. I have attached the report and appreciate any help with this! BIV...
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    Wiki Diagnosis for Cath

    I am being audited and questioned on the diagnosis I used when coding the attached report. I would really appreciate if someone could read the report and tell me their choice of diagnosis. I need to know if I have a leg to stand on to rebutt her findings. CARDIAC CATHETERIZATION REPORT...
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    Wiki PPM Implant Biventricular and Diagnostic EPS

    attached is a report that I coded and I'm getting a claim error on it saying I'm missing the primary code. Can someone take a look for me? I coded 93623, 93620 and 33225. Patient was brought to the EP lab in the fasting state. The right groin was prepped in the usual manner. Under...
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    Wiki Trapped Swan-Ganz catheter

    Is there a code for A repeat median sternotomy with cardiopulmonary bypass with removal of Swan-Ganz catheter? When researching I read that I should code a right heart cath but that doesn't seem right to me. This patient had undergone surgery several days prior with a Swan-Ganz catheter...
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    Wiki PPM Implant Biventricular

    I'm struggling with these PPM BiV insertions. I'm confused by the note and would like another set of eyes to read it and see how you interpret it. BIVENTRICULAR PACER IMPLANTATION PROCEDURE PERFORMED: Biventricular pacemaker implantation using an existing left ventricular epicardial lead...
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    Wiki BiVPPM

    I am having trouble with this one. I have studied the note and I don't see 3 leads which is what you need for BiV PPM insertion. So, I'm struggling with the coding. One option I believe is: 33207 – insertion of new perm pacemaker with transvenous electrode(s); ventricular 33216 – insertion of...
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    Wiki 75710 & 75630

    I coded this note as 37224, 75710-26,59 and 75630-26,59 Now I'm second guessing myself. And while I think that the 75710 would also be separately billable from the 37224 and eligible for the -59 modifier I’m a little less clear on whether it is separately billable from the 75630. There is...
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    Wiki codes 75630 and 75710

    I coded this note as 37224, 75710-26,59 and 75630-26,59 Now I'm second guessing myself. And while I think that the 75710 would also be separately billable from the 37224 and eligible for the -59 modifier I’m a little less clear on whether it is separately billable from the 75630. There is...
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    Wiki Aortic Root Repair, Aortic Valve Replacement

    I could use some help and advice on how to code this. At first I thought it was fairly simple but now I'm second guessing myself. Help! PREOPERATIVE DIAGNOSIS: 1. Marfan syndrome with acute type A dissection and cardiogenic shock. 2. Suspected early tamponade. POSTOPERATIVE...
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    Wiki explant infected TAVR valve

    My docs explanted an infected TAVR valve and implanted #25 Edwards Inspiris Resilia bioprosthesis, ascending aorta replacement #30 Hemashield graft. I have never coded an explant and have no idea what code to use for that. Anyone have any ideas on how to code this? Thanks so much for any help!
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    Wiki I need some advice with this one

    I have 2 reports a day apart. There is so much going on that I'm not sure I'm coding it correctly. I don't know if I'm even close to getting it right. Can anyone help me with this? My tentative coding is...first report...33465,33405,33430,33202 and second report...33530,33465,33020 Here are...
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    Wiki 93571

    I'm having lots of denials for 93571. I use the 26 modifier because they are done in the Cath Lab. I identify the vessel but they still deny. I usually do them with a left heart cath and I add the 26 and 59 modifier to that. What am I doing wrong? Why would these deny?
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    Question BiV ICD insertion utilizing previously placed LV lead

    A BiV ICD was implanted using a pre-existing left ventricular lead. RV and RA leads were delivered. I need help coding this. My first guess was 33249 but I don't think that's right. I also looked at 33264 but there wasn't a previously placed device. Any advice? Thanks so much!
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    Wiki CCC Specialty Exam

    I am preparing to take the CCC exam and the majority of posters on here suggest the CSI Coding Strategies Comprehensive Cardiology as the reference book of choice. This is a pretty expensive book...does anyone know if these can be purchased used and possiby cheaper?
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    Wiki cavotricuspid isthmus ablation

    How would you code for a cavotricuspid isthmus ablation when it is done for atrial flutter/atrial fibrillation and not for SVT?
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    Wiki new X modifiers

    Does anyone know which modifier would apply if one doctor did the Cath and a different doctor in the same practice did the Stent same day? I'm torn between the XP and the XU. I have read on here that it's suggested to use the XU with a diagnostic Cath when Stent is done same day same doctor. I'm...
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    Wiki Cath, PCI and Stenting

    One doctor in our practice did a left heart catheterization, limited coronary angiography, percutaneous coronary intervention and stenting of the obtuse marginal branch and the nondominant circumflex artery. We coded 93458-26, 92928-LC, 92929-OM. Later that day the patient was having a lot of...
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    Wiki Need Help ICD to Pacemaker

    One of my doctors removed an A-BiV Implantable Cardioverter Defibrillator and Implanted an A-BiV Pacemaker using existing leads. I'm not sure how to code this. Any suggestions? Thanks!
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    Wiki Diagnostic and Intervention 2 different doctors

    When there is one doctor in our practice doing a diagnostic cardiac catherization and a different doctor in our practice doing the intervention, same session, how can I report and get paid for both?
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    Wiki Fiducial Markers Placement Breast

    I work for a General Surgeon and he placed fiducial markers in the breast of a patient seen in our office. Are there any CPT codes to cover this? I can find one for prostate but I haven't found anything for breast. Thanks for any help you can give me!
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    Wiki Multiple Ventral Hernias

    I'm a fairly new coder and my surgeon did a Laparoscopic ventral hernia repair with multiple hernia defects on a patient and I'm unsure how to code it. He used a 30x20 cm mesh to cover the entire anterior abdominal wall with having at least 4 separate large defects. I would appreciate any help...
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